ACTE Executive Forum

Registration Form


All fields are required unless marked with a "*". Name, Title and Company will appear on badge as submitted.
Name
Title
Company/Affiliation
Address
Address*
City
State/Province*
Zip/Postal Code
Country
Telephone
Facsimile*
E-Mail

	Early Bird Registration Fees: 50% off before 31 October ACTE Member €75 Euro Non-Member €112.50 Euro* Non-Member Joining €335 Euro Standard Registration Fees:** After 31 October ACTE Member €150 Euro Non-Member €225 Euro* Non-Member Joining €410 Euro** Complimentary €0 Euro ( If registering as a comp, please include "code") * Please note the ACTE membership is individual membership only. ** Benefits include membership for the entire year and savings to all ACTE Conferences, free subscription to ACTE Global Business Journal and more.
Payment:
	Cheque (payable to ACTE) American Express Diners Club Eurocard/MasterCard Visa
Cardholder Name
Card Number
Expiry Date
	Should you use another means of payment, we will use your credit card number as a guarantee for payment. Your credit card will then only be debited within 2 weeks after the first forum date.
(Note: To pay by check, please do not submit this form on-line.Instead use your browser's print feature to print the completed form, make written note that a check has been mailed, and fax it to 32.2.743.15.50. You should also print this form if you require a receipt of registration.) You may submit this form online by Fax: 32.2.743.15.50 or Mail: ACTE EMEA, Avenue des Gaulois, 7 - B-1040 Brussels. You may call 32.2.743.15.89 for questions or more information. (Full refund less a handling fee of Euro 50 per registrant will be granted to request received in writing before or on the 11 March 2002. No refunds will be granted for requests after that date. Telephone cancellations will not be accepted.)