<p> Registration Form DOING BUSINESS WITH BRICS CONFERENCE The Eurasia Center & The Eurasian Business Coalition </p><p>Principal Contact: ______</p><p>Position: ______</p><p>Firm/Organization: ______</p><p>Address: ______</p><p>City/State/Zip Code: ______</p><p>Tel/Fax: ______</p><p>Email: ______(Early Registration Discount) Conference Participant: $300 (Only $175 if you Register before May 18th) ___ 100% Tax-Deductible (Conference Participant fee includes Lunch & Evening Reception and transportation between venues)</p><p>Only Special Russian Embassy Evening Reception ($50): ______50% Tax-Deductible</p><p>Participant’s Name: ______</p><p>*Paid by Credit Card (X): ___VISA ___MasterCard ___AMEX ___Discover (No Debit Cards)</p><p>Card in Name of: ______</p><p>Credit Card Number: ______</p><p>Address of Card Holder (must match card used): ______</p><p>Expiration Date: ______*(by check) ______Questions Call: 202-494-0773</p><p>Names of other Guests (if any) ______</p><p>This Form may be emailed to: [email protected] </p><p>Make check payable to: The Eurasia Center Registrations can be faxed to: 202-237-1452 or mailed to the: The Eurasia Center/EBC Doing Business with the BRICS Conference 4927 Massachusetts Avenue, NW Washington, DC 20016 USA</p><p>Please contact Michael Cooper, at The Eurasia Center (202) 494-0773 [email protected] </p>