Registration

Yes, I would like to register for the event:
		I am a Pharma Manufacturer, please register my free place at the 2-day conference*
		I am a Pharma Manufacturer, please register my free* place at the Pre-Conference Workshop
		I wish to receive a hard copy of the documentation for non-delegates $450
		I am a Pharma Vendor/CRO, I am interested in this event and would like to be contacted regarding how my firm can be involved with this conference
Fee* This event is strictly by invitation only. There a limited number of FREE PLACES* at the pre-conference workshop and the 2- day conference which are reserved for Pharma Manufacturers. ViB events reserve the right to allocate places and to refuse applications or to charge a nominal attendance fee once the number of complimentary places has been exceeded.

* fields are mandatory

Title:*

Name:*

Job Title:*

Company:*

Address:*

Town/City:*

Country:*

Post/Zip code:*

Telephone (Switchboard):*

Telephone (Direct):*

Fax (Switchboard):*

Fax (Direct):*

Email:*

Corporate Website:*

Company VAT :*

Reference (if any) *
Don't know your reference,
click here

Please state how you heard about this conference:*

APO (American Pharmaceutical Outsourcing)

PharmiWeb

World Pharmaceutical Frontiers

Supply Chain Market

Pharmaceutical Online

PharmaVOICE

PharmCast

Drug development Technology

Other, please specify

* fields are mandatory


	Yes, I would like to receive timely and relevant information from ViB events via e-mail and telephone.

	Data Protection Personal Data is gathered in accordance with the Data Protection Act 1998. Your details may be passed to other companies who wish to communicate with you offers related to your business activities. If you do not wish to receive market information and details of relevant products and services by email, please tick here.

Terms and Conditions:

Payment details
Please note we require payment in advance. You can pay by cheque (drawn on a UK bank) payable to ViB events or by bank transfer to Lloyds TSB, account number 01492549, sort code 30-00-02. Please quote delegate name and conference code VCLA2006 on all payments.

Cancellations
All cancellations after October 9th 2006 are subject to a cancellation fee, although a suitable replacement delegate is welcome. Cancellations may be made by telephone, but must be confirmed in writing. Please quote the appropriate reference VCLA2006.

YES, I have read and understood the above terms and conditions and am happy to proceed with my registration*

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