ChemCon Europe 2021: Promotional Package Order Form London, United Kingdom, 26 - 29 October 2021 Please complete the online registration form below and click the SUBMIT button to finalise the process. In case you encounter any problems, please contact us directly at office@chemcon.net or use the PDF registration form to submit your registration. 1. Select Package Display PackageDisplay Package Add Exhibition Package Exhibition Package, new prints Add Exhibition Package, reusing prints from a previous conference Add Partner Package Partner Package Add Partner Package with Exhibition Package Add Add Partner Package with Exhibition Package using prints from a previoud conference Add Add Display Package Price: 1.500,00 € Exhibition Package, new prints Price: 4.500,00 € Exhibition Package, reusing prints from a previous conference Price: 4.000,00 € Partner Package Price: 15.000,00 € Partner Package, including Exhibition - new prints Price: -500,00 € Partner Package, including Exhibition - re-use prints Price: -500,00 € Total 0,00 € 2. Personal InformationTitle Dr. Title Mr Title Ms Title Other Your Name* First Last Company*Job Title* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneYour Email* Enter Email Confirm Email VAT-ID No. (for companies based in the EU only)Purchase Order No. (if applicable)3. Registration ConditionsPrices are exclusive of VAT. Only a limited number of packages are available. Orders will be handled on a first-come-first-served-basis with partner priority for exhibition stands until July 30th, 2021. A confirmation of registration and invoice will be sent to you within three days after receipt of your order form. Your participation is only guaranteed when payment is fully received before the deadline given in the invoice. It is regretted that fees for promotional packages are not refundable. Only in case of cancellation of the event by HaskoningDHV Nederland B.V. (except in cases of force majeure) refunds will be made and are limited to 50% of the issued amount. In case of cancellation of the event by HaskoningDHV Nederland B.V. due to a force majeure event (i.e. any cause beyond HaskoningDHV Nederland B.V.’s reasonable control which makes it impossible to host ChemCon Europe 2021. Such causes shall include but not be limited to: Acts of God, civil or military authority, government priorities or government regulations, fires, floods, epidemics, pandemics, war (declared or undeclared) riots, strikes.) before September 24th, 2021, the fees actually paid will be transferred to be used for the next ChemCon conference. Positioning of partner logos is due to the organiser and will be done as soon as payment is received. The personal information on this form provided by you will be held on database and used for communication matters. For exhibition packages also the Exhibition Regulations apply. In addition to the conditions mentioned above this contract is subject to the law of the Netherlands. By submitting your online registration form:*(1) You agree to the Registration Conditions. (2) You agree that the personal information on this form provided by you will be held on database and used for communication matters (to send you specific conference information and our general newsletter (approx. six times before each conference)). To ensure delivery to your inbox, please add office@chemcon.net to your address book or safe list. For more information, please read our Privacy Statement. I agree to all terms and conditions 4. PaymentSelect your preferred payment method (you will receive an invoice within three working days)*Credit Card (invoice including payment link)Bank Transfer (invoice including bank details)SUBMIT Please select package NameThis field is for validation purposes and should be left unchanged.