Delegate Registration Form

Delegate Registration Form Please complete the entire form! 4 EASY WAYS TO REGISTER Telephone +971 4 3539750 Fax +971 4 3539760 Email [email protected] Mail 405, Al Arif Business Bay, P.O. Box 126093, Dubai, United Arab Emirates � Mr � Ms Delegate Name Organization: Designation: Address: City: Postal code: Country: Telephone: Fax: Mobile: Email: For International Delegates: Arrival Date: Flight Number Departure Date: Flight Number Name of accompanying person/s: Registration fees: � Delegate Fees - US $ 400.00* (NET) per delegate (Fee includes entrance to the 2 day Forum including Lunch, Pre Conference networking cocktail on 16th February 09, Gala Dinner on 17th February 09 and launch of the Dubai Pearl Exchange on 18th February 09 ) � Accompanying Persons – Fee US $ 200.00* (NET) per person (Fee includes attendance at Pre Conference networking cocktail on 16th February 09, Gala Dinner on 17th February 09 and launch of the Dubai Pearl Exchange on 18th February 09 ONLY, otherwise full delegate fee is applicable) Special Fees: � Early bird (Booking before 15th November 2008) – Fee US $ 325.00* (NET) per delegate � Dubai Pearl Exchange Members - Fee US $ 300.00* (NET) per delegate � Corporate groups (minimum 5 delegates representing same company) – Fee US $ 325.00* (NET) per delegate * Rooms reserved for delegates at the Atlantis are to be booked directly with hotel on a first come first serve basis. The delegate fee does not include accommodation. Payment Options I Prefer To Pay By: � Bank Transfer: UAE Dirham or USD transfer to; Beneficiary: Dubai Pearl Exchange DMCC Account No. 021 699301 001 Account Name: Dubai Pearl Exchange DMCC HSBC Bank, Main Branch, P.O. Box 66, Dubai, UAE Swift Code: BBMEAEAD � Local Cheque/Demand Draft: Please enclose cheque or demand draft drawn in favour of BUZ Consulting DMCC (CHEQUES ARE ACCEPTED FROM UAE COMPANIES ONLY) � Credit Card: Please complete credit card information below; Card Holder’s Name: Signature: (as it appears on the card) � Diners Club � Visa � MasterCard Credit Card No: CVC/CVV: Date of issue: Expiry Date: Note: Below Copies to be faxed at +971 4 3539760 or email to [email protected] with the above information: 1. Copy of credit card (both side) 2. Copy of personal identification (residence card/passport photocopy including signatures) Important • Please return this form by no later than 31st January, 2009 • Bank Transfer, Credit Card OR Local Cheques/ Demand draft payments must be received by no later than 31st January, 2009 Hotel Accommodation The delegate fee does not include Hotel Accommodation. Please contact Atlantis Hotel, Palm Jumeirah for room reservations. • Atlantis Hotel Contact Details: Ms. Cassandra Tavares, Manager, Group Reservations Telephone: +971 4 367 2001,Fax: +971 4 366 4070, Email: [email protected] • Hotel Accommodation Hotel accommodation has been arranged at several hotels. Please see full details on the website www.dpe.ae/wpf or contact the appointed Event Organisers. Appointed Event Organisers BUZ Consulting DMCC Contact Person: Honey Barba 405, Al Arif Business Bay P.O. Box 126093 Dubai, United Arab Emirates Tel: +9714 3539750 Fax: +9714 3539760 Email: [email protected] Do You Require A Visa Or Transportation? If yes, please contact the hotel directly. • Visa into the UAE G.C.C. Nationals, Western European, North American, Australasia and some South East Asian Nationals do not require a visa to enter the UAE. Other nationalities need to fax a copy of the passport (relevant pages) to the hotel and credit card payment to facilitate visa processing. It takes approximately one week to get the visa, depending on the nationality. Please contact your local UAE Embassy for further visa information details and any changes in visa policies policies or visit www.dubaitourism.ae Terms and Conditions • Entry to the Forum: The entry to the Forum will not be guaranteed or confirmed unless the payment is received. Dubai Pearl Exchange or its affiliates are not responsible for any damages or claims by the delegates. • Cancellation and Transfer: Should you be unable to attend the Forum, a substitute delegate is welcome at no extra charge. A full refund, less 10% administrative charges will be made for cancellations received in writing at least 3 weeks prior to the conference. • General: Dubai Pearl Exchange reserves the right to cancel or alter the content and timing of the program or the identity of the speakers for reasons beyond its control. • Data Protection: The personal information shown in this form or provided by you will be kept confidential. The database will be under the organiser’s sole use..

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