Gas Processors Association

Gas Processors Association - Europe Registration form for 201 Annual Conference, Budapest, 13 – 15 September 2017 Please complete by either selecting from drop-down boxes or completing text entry, save as pdf email to Sandy Dunlop at GPA Administration Office [email protected] You may need to “Allow Editing”

Title First Name Family/Surname

Click or tap here Click or tap here to enter text. Click or tap here to enter text. to enter text. Invoice Company Click or tap here to GPA E Member? ☐ enter text. Job Title Click or tap here to YP Discount Applicable? ☐ enter text. Preferred Name on Preferred Company Name Click or tap here to Click or tap here to enter text. Badge enter text. on Badge

Invoice Address 1 Click or tap here to YP Discount available to Engineers with less than 5 years’ experience enter text. Invoice Address 2 Click or tap here to Preferred Currency Choose an item. enter text. Invoice Town Click or tap here to Dietary Requirements Choose an item. enter text. Invoice Click or tap here to Other Special Requirements Click or tap here to enter text. Region/State enter text. Invoice Zip/Post Click or tap here to Email Click or tap here to enter text. Code enter text. Invoice Country Click or tap here to Phone (inc. Country Code) Click or tap here to enter text. enter text. Companion’s Full Name Click or tap here to enter text. Attending Companions Tour? ☐

Package Selected Two Nights ☐ ☐ (See Conference Details) ☐ One Night No Nights

Accommodation (night of) 13 Sept inc. 14 Sept inc. 13 Sept ☐ 14 Sept ☐

Double/Single Choose an item. Choose an item.

Additional Accommodation Required 10 Sept 11 Sept 12 Sept 15 Sept 16 Sept 17 Sept These will be requested but are not guaranteed until ☐ ☐ ☐ ☐ ☐ ☐ confirmed by hotel

Other Nights Required Please Provide Details Click or tap here to enter text.

Payment Method PayPal ☐ Credit Card ☐ American Express ☐ Bank Transfer ☐

To pay by Credit Card or American Express, please send form and call Administration Office with CC details. Payment will be taken in Sterling. Do not send CC detail by email or fax. If you wish to pay by Bank Transfer, please advise GPA Europe who will provide an invoice with full bank details. Please confirm whether you wish to pay in Sterling or Euros. Cheques are no longer accepted for Payment Please note GPA Europe cannot accept any bank charges on money transfers.