I Hereby Register for the Above Fact-Finding Mission

Registration for the fact-finding mission from Bulgaria to Germany focusing on “Energy efficiency in the process industry” and taking place from 02/11/2016 to 05/11/2016 as part of the Federal Ministry of Economic Affairs and Energy’s German Energy Solutions Initiative, and organised by eclareon GmbH.

The participation in the fact-finding visit and the transfers to the visits within Germany are free of charge. However, participants are requested to bear travel expenses to and from Germany, as well as the costs for accommodation and meals by themselves.

Institution / company name: Surname / first name: Job title / department: Address: Postcode: Phone / mobile / fax: Email: Website:

Type of institution: Public authority / Ministry Company administration NGO Other: Energy agency Your expectations regarding the fact-finding mission:

I hereby register for the above fact-finding mission. I agree to my personal data (name, phone number, email address) being saved by eclareon GmbH, used for purposes relating to this event, and passed on to the Federal Ministry of Economic Affairs and Energy for the purposes of evaluating the event.

My personal data will not be forwarded on to third parties (with the exception of those listed above). I can withdraw my consent to the above at any time. If I do so and my personal data is no longer required for the above purposes, it will be deleted.

Place, date Signature, company stamp

Please return completed form to: Tzanko Tzankov Leiter DEinternational German- Bulgarian Chamber of Industry and Commerce | AHK Bulgarien F. Joliot-Curie Str. 25 A | BG-1113 Sofia T +359 2 81630-24 | F +359 2 81630-19

Facilitator [email protected]