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1. REGISTRATION (* Mandatory fields)
Event selection: * 08.11.2012 ECR Baltic Forum, Vilnius early bird registartion: members EUR 99.00 non members EUR 125.00
Are you an ECR Baltic member? Yes No
Discount code:

2. DELEGATE INFORMATION
First Name: *
Family Name:*
Job Title: *
Supply Chain & Logistics
Purchasing
Category Management 		Financial
Sales
Marketing 		IT
General Management
Other, please specify below:

Full Company Name*
Company Reg. number*
VAT number*
Office Address:*
Post Code: *
City:*
Country:*
Invoice Address (if different from the above):
Telephone:*
Fax:
E-mail:*
May we print your e-mail in the participant's list? Yes No

3. TYPE OF ACTIVITY*
Retailer
Service provider 		Manufacturer
Other, please specify below: 		Distributor

4. COUNTRY OF ACTIVITY*
Estonia
Baltics 		Latvia
Other, please specify below: 		Lithuania

5. SIZE OF ORGANISATION*
(*Number of full-time employees in Baltic States)
Up to 20 20-100 More than 100

6. CURRENT LEVEL OF INTERACTION WITH ECR ACTIVITIES*
Not involved so far Informed about ECR Participating (incl. outside Baltic's)
Comments:
I have read terms & conditions:
Security code
Enter security code: *

 

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