2018 Summit Registration First Name (AS IT WILL APPEAR ON YOUR SUMMIT BADGE) Last Name (AS IT WILL APPEAR ON YOUR SUMMIT BADGE) Title/Position (AS IT WILL APPEAR ON YOUR SUMMIT BADGE) Company/Organization (AS IT WILL APPEAR ON YOUR SUMMIT BADGE) Your Email (required) Address (required) City State Postal Code Country (required) Telephone Number (required) Fax Number 2018 Registration Payment Select Registration Fee Amount (required) Fee is in Euros (€) for those within Europe and US Dollar ($) for the rest of the world. Registration Fee includes the three-day conference, all meals from evening of April 26th to closing on April 28th, transportation to any outside venue, simultaneous interpretation for all sessions, and all program materials. $1,000 Corporate Rate (for participants from corporations)$675 Non-Profit/Small Business Rate (for participants employed by non-profits or small business)$375 Spouse/Son/Daughter Rate (Includes Evening Events ONLY) Cardholder Name (required) Card Type (required) Account Number (required) Expiration Date MM/YY (required) Organization Code (for Members and Partners) Professional Profile Occupation CorporateEntrepreneurGovernmentNGOAcademicOther For Business Registrants Only: Please select Industry AgricultureBusiness ServicesCommunicationsConstructionConsultancyEnergyFinancial ServicesFood/BeverageHealth CareInfo. TechnologyManufacturingMediaMiningPharmaceuticalsRetailTransportationTourismWholesaleOther Summit Special Sessions Please indicate in which meal sessions you plan to participate. Note that meal counts will be provided to the venue based on accurate selections of which meal sessions you will attend. Should your plans change following submission of this form, please update your selections via email to firstname.lastname@example.org (required) Welcoming Dinner on April 26Networking Breakfast on April 27Lunch on April 27Gala Dinner on April 27Networking Breakfast on April 28Lunch on April 28Closing Dinner on April 28 Are you vegetarian? ---YesNo Do you have any special dietary needs? Photo for Registration Badge (required) CANCELLATION POLICY: In the event that you must cancel your registration, notice of cancellation must be submitted in writing to email@example.com before March 25, 2018 to receive a refund. There will be a 10% processing fee against the cost of the registration to cover extremely high banking fees for refunds. For cancellations received after March 25, 2018, no refund will be issued.