Registration Form Belt CL

Registration Form

March 22th & 23th, 2018

Hotel Sheraton Miramar

Av. La Marina Nº15,

Viña del Mar - Chile

Participant Data:

Name(s): Write name here

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E-mail: Write e-mail here

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Job Title: Write job title here

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Direct Phone Nº: Write direct phone number here

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Job Title: Write job title here

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Company: Write company here

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Contact: Write name here

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Cell Phone Nº: Write cell phone number here

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ID Nº: Write ID number here

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Telephone: Write telephone here

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Business Name: Write businnes name here

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E-mail: Write e-mail here

Id Nº: Write ID number here

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Business Line: Write business line here

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Responsible Bill Payment: Write responsible bill payment here

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Cell Phone Nº: Write cell phone number here

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I have read and accept the terms and conditions

Es Obligatorio Leer y Aceptar

Responsible Issuing PO:

Billing Data:

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Conditions Of Registration:

Cancellation Policy:

The companies that attend the congress as NON Sponsors cannot distribute any kind of merchandising during the congress.

Edoctum reserves the right of admission in order to achieve the objectives of our Congress.

Only, Cancellations made in writing will be accepted up to thirty (30) days before the date of the Congress, thereafter all registered participants must pay the full value of Congress. If the registered participant does not attend the Congress and no cancellation has been made thirty days in advance, must pay the full value of Congress.

Cost Per Participant:

General Cost until january 19th, 2017

(Cost Closed)

General Cost until fabruary 21th, 2017

(Cost Closed)

General Cost since fabruary 22th, 2017

CLP $ 470.000 (Tax-Exempt)

Speaker's Fee

CLP $ 260.000 (Tax-Exempt)

Teachers and Students Fee

CLP $ 220.000 (Tax-Exempt)

Payment Options:

Purchase Order:

Nominative Check made payable in the name of Edoctum S.A. and send to address Rosario Sur 91, Oficina 703, Las Condes, Santiago, Chile.
Deposit in Bank Account Nº 10597956, Banco de Crédito e Inversiones (BCI) in the name of Edoctum S.A. Send the copy of the deposit to pagos@edoctum.cl.
Bank Wire Transfers in the name of Edoctum S.A. Id Nº 76.008.208-2, Bank Account Nº 10597956, Banco de Crédito e Inversiones (BCI).
Payments made from abroad with deposit or transfer in dollar should be made in the name of Edoctum S.A., Account Nº 11162899, Banco BCI’s account number held at Wachovia Bank: /2000192291712, Account Name: Banco de Crédito e Inversiones–BCI, Address: Huérfanos 1134, City/Country: Santiago/Chile, Swift Code: CREDCLRM.

Registration must be paid in full before the date of the Congress,

Otherwise the registered person will not be authorize to participate.

Purchase Order should be issued in the name of Edoctum S.A., Id Nº: 76.008.208-2, Business Line: Eventos Técnicos, Cursos, Seminarios, Convenciones y Congresos, Address: Rosario Sur 91, Oficina 703, Las Condes, Santiago, and send via E-mail to pagos@edoctum.cl. The Purchase Order must be attached to this application form, otherwise Edoctum S.A. will proceed to issue invoices without this support.

Valid Registration Form as Purchase Order.

Conditions:

The registration fee includes: Access to technical sessions / Technical Material (Pendrive) / Congress Bag / Lunch (2) / Coffee-breaks (3) /Cocktail and Welcome Dinner (1)

The value does not include:

Costs of stay, air tickets and / or transfers.
Parking subject to availability.
Edoctum reserves the right to suspend the congress for lack of a quorum.
Registrations with LIMITED PARTICIPATION