Delegate Registration Form

Your Delegate Package includes:

Access to all keynotes, sessions & group discussions
Optional 1-to-1 meetings with peers and solution providers
Dedicated Event Operations Manager support
Speed networking sessions
Drinks reception, lunch & coffee breaks
Fun activities like Snap & Share Contest!

Note: Your email may be shared with other participants for networking purposes. If you prefer not to share it, please inform your POC in advance.

Cancellation of Registration:

If you cancel your registration less than Six weeks (other than health issue) before the Event commencement date you will incur a charge of £599.
Cancellation fees can be avoided by providing replacement delegates from your organization. Replacement should be of the same/ equivalent job title.

Fields marked * are mandatory. Please complete each field in this form to ensure prompt acceptance of your application.

First Name*

Sur Name*

Email Address*

Phone*

Company*

Job Title*

Point Of Contact (If Any)

What are your key priorities for the next 6 to 18 months?

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							Key Priority
						
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							Key Priority
						
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							Key Priority

Which other colleagues and decision makers should also be invited?

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							Name
						
							email
							
							Email
						
							work
							
							Job Title

Attending as a?*

Speaker

Delegate

What are your industry sectors?*

Pharmaceuticals

Biotechnology

Hospital/Healthcare

Medical Devices

Other? Please Specify

What is your role in purchasing decision for your company?*

Decision Maker

Recommended

Influence

Other? Please Specify

Scope of responsibility?*

Departmental

Regional

European

International

National

Other? Please Specify

In which region you are planning to purchase the products and services?*

Participation Fee:

Your Signature

Date

Any Comments?

I agreed the above terms & conditions