Delegate Registration Example • European Supply Chain Summit

Example Delegate Registration Form

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Invoice Number

Attendee Details

Please provide details for the primary registrant. All fields are required.

Name*

First Last

Job Title*

Company*

Location

Street Address City Country

VAT identification number

Email*

Phone*

Mobile Phone*

Please provide your direct contact number (including extension). This allows our success coordinators to reach you in regards to any deliverables required for your participation prior summit!

LinkedIn Profile Link

LinkedIn Consent

I agree to share my LinkedIn profile for verification purposes

On-Demand?

Yes

Additional Passes

Add more passes for any additional attendees.

Second Attendee

Details for additional attendees, if available.

Name*

First Last

Job Title*

Email*

Phone*

Mobile Phone

LinkedIn Profile Link

LinkedIn Consent

I agree to share my LinkedIn profile for verification purposes

On-Demand?

Yes

Third Attendee

Details for additional attendees, if available.

Name*

First Last

Job Title*

Email*

Phone*

Mobile Phone

LinkedIn Profile Link

LinkedIn Consent

I agree to share my LinkedIn profile for verification purposes

On-Demand?

Yes

Fourth Attendee

Details for additional attendees, if available.

Name*

First Last

Job Title*

Email*

Phone*

Mobile Phone

LinkedIn Profile Link

LinkedIn Consent

I agree to share my LinkedIn profile for verification purposes

On-Demand?

Yes

Fifth Attendee

Details for additional attendees, if available.

Name*

First Last

Job Title*

Email*

Phone*

Mobile Phone

LinkedIn Profile Link

LinkedIn Consent

I agree to share my LinkedIn profile for verification purposes

On-Demand?

Yes

Sixth Attendee

Details for additional attendees, if available.

Name*

First Last

Job Title*

Email*

Phone*

Mobile Phone

LinkedIn Profile Link

LinkedIn Consent

I agree to share my LinkedIn profile for verification purposes

On-Demand?

Yes

Additional Details

Please provide further details about your organization or interest in further participation.

Q1. How many people are employed by your organization as a whole?

Q2. Approximately what is the annual revenue generated by your organization as a whole?

Q3. Are you interested in future opportunities to present on the agenda?

Yes

Q4. Are you interested in contributing to the Generis Blog?

Yes

Q5. Permission to acquire your bio from LinkedIn?

Yes

Q6. What are your top three business challenges?

Q7. What are the top three solution providers you would like to see at future meetings?*

Q8. Which industry do you represent?*

Areas of Specialization

For pre-scheduled one-to-one business meetings, which of the following areas are you interested in?

Approximately how much is your company planning to invest in the above areas?*

Terms & Conditions

Please review the Terms & Conditions and Privacy Policy. Your Date of Birth will act as your digital signature.

Terms & Conditions

Booking Code

Please confirm your Date of Birth:*

Package Option

VIP Delegate Package — European Supply Chain Summit

Price:

On-Demand Content

Price: 199.00 €

Transfer - European Supply Chain Summit

Price:

Event Year

Discount Code

If you have a promotional discount code, enter it here.

Discount

Price:

Subtotal

0.00 €

Service Fee

Price: 0.00 €

VAT (19%)

Price: 0.00 €

Total

Including 18% service fee.

Payment

Payment is processed securely through our payment processor. We do not retain any payment information.

Payment Method*

Credit Card

PayPal

Submit Credit Card Information

Credit Card

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Example Delegate Registration Form

Attendee Details

Additional Passes

Second Attendee

Third Attendee

Fourth Attendee

Fifth Attendee

Sixth Attendee

Additional Details

Areas of Specialization

Terms & Conditions

Payment

Contact

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