Register – Contact Information

* Title

Please select Mr Ms Mrs Miss Dr Prof A value is required.A value is required.

* First name

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* Family name

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* Organisation

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* Position

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* Organisation type

Please select Corporate Organisations EuroCommerce Member EuroCoop Member European Retail Round Table Member Independent Retail Europe Member European Commission/Parliament/Council EU Permanent Representations National Governments/Regulators/Diplomatic Missions Press/Media Academic/Student NGOs/Not-for-profit A value is required.A value is required.

* Address line 1

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Address line 2

Address line 3

* City/Town

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* Postcode

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* Country

Please select Austria Bulgaria Belgium Croatia Cyprus Czech Republic Denmark Estonia Finland France Germany Greece Hungary Italy Ireland Luxembourg Latvia Lithuania Malta Netherlands Portugal Poland Romania Slovenia Slovakia Spain Sweden United Kingdom Afghanistan Albania Algeria American Samoa Andorra Angola Antigua and Barbuda Argentina Armenia Aruba Australia Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Channel Islands Chile China Colombia Comoros Congo, Dem. Rep. Congo, Rep. Costa Rica Côte d'Ivoire Cuba Djibouti Dominica Dominican Republic Ecuador Egypt, Arab Rep. El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Faeroe Islands Fiji Gabon Gambia, The Georgia Ghana Gibraltar Greenland Grenada Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong, China Iceland India Indonesia Iran, Islamic Rep. Iraq Isle of Man Israel Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Dem. Rep. Korea, Rep. Kosovo Kuwait Kyrgyz Republic Lao PDR Lebanon Lesotho Liberia Libya Liechtenstein Macao, China Macedonia, FYR Madagascar Malawi Malaysia Maldives Mali Marshall Islands Mauritania Mauritius Mayotte Mexico Micronesia, Fed. Sts. Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar Nepal Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Puerto Rico Qatar Russian Federation Rwanda Samoa San Marino São Tomé and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Solomon Islands Somalia South Africa Sri Lanka St. Kitts and Nevis St. Lucia St. Vincent and the Grenadines Sudan Suriname Swaziland Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Uganda Ukraine United Arab Emirates United States Uruguay Uzbekistan Vanuatu Venezuela, RB Vietnam Virgin Islands (U.S.) West Bank and Gaza Yemen, Rep. Zambia Zimbabwe A value is required.A value is required.

* Phone

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Mobile phone

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* E-mail address

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* Confirm e-mail

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Belgian VAT registration

Please tick if registered for Belgian VAT

PO number

How did you hear about this event?

Maximum 255 characters (including spaces).

* Contact/delegate

Are you attending the event, or are you making the booking on someone else's behalf?

 Attending the event
 Booking for someone else Please select an item.