AFCEA Global Intelligence Forum Brussels 2013

Le Plaza Hotel, Brussels, Belgium
10-11 December 2013

If you are a speaker or a guest, please email us to register.

If you would like to get in touch with the AFCEA Registration Staff, please call + 32-2-705 2731 or email us.

If you would like to join AFCEA to benefit from the member rate at this event, join online at http://www.afcea.org/membership/ before completing this form.

If you would like to get in touch with the AFCEA Registration Staff, please call + 32-2-705 2731 or email: europe@afcea.org

Complete this form for each attendee.

Required fields indicated by *

Mr/Mrs/Ms or Military Rank *

First Name *

Last Name *

University/Company or Government Org Name *

Note: the four fields above will be used to produce your badge
but may be edited so as to fit on 3 lines of text.


Job Title *

Address *

City/State/Postal Code *

Country *

E-mail *

Additional E-mail

Mobile Phone or Tel *

Check here if billing address is the same as the attendee address

Billing Contact Name *

Billing Email *

Billing Company/Organization *

Billing Address *

Billing City/State/Postal Code *

Billing Country *

How did you learn about this event?


Industry
Check here if you are a member of industry.


VAT INFORMATION:
  • All fees are in Euros and subject to VAT (Value Added Tax) at 21%
  • NATO personnel and some Diplomatic Missions may be exempt from VAT charges but must provide a VAT Exemption Certificate otherwise VAT will be charged. The Certificate must be provided as soon as possible. Please let AFCEA Europe know if you intend to provide one.
        My company has a (European) Value Added Tax (VAT) number
        No Yes
        (Country of VAT registration and of billing address must be the same.)
        VAT Number:

Select Item(s) *

Symposium Fees include Sessions, Networking lunches, and refreshments during the coffee breaks.

All fees are in Euros


Comments/Special Needs:

Information such as special dietary restrictions or physical access needs.


Credit Card Payment *

Card Type

Cardholder Name

Card Number

Expiration Date
MM/YY

AFCEA Europe will email a Registration Confirmation as soon as your credit card payment is accepted. A "Paid" invoice will also be emailed for accounting (tax) purposes to you or to the billing contact named on your registration.
15% administration costs will be charged for cancellations prior to 11 November - no refund after that date. Name substitution: at any time.
Data Protection
The data on this form will be held in a database and used for AFCEA internal purposes only.