WCFDavos|CERN session
World Communication Forum in Davos (WCFDavos) and The European Organization for Nuclear Research (CERN) CERN premises: 385 Meyrin Road, 1217 Meyrin, Geneva, Switzerland 09 March, 2015 Please, complete the form by typing in all due information, print it, and return as a scan via email. For further queries, please email us at: forum@forumdavos.com * NB! > Offer with Preferential terms for joining the WCFDavos summit on 10-11 March, 2015! Personal information – Please type in all the requested data, as advised below! Title: -Mr. -Mrs. -Ms -Dr. -other: (please, specify) Type “x” in the middle of the appropriate box Sex: -Male; -Female; Type “x” in the middle of the appropriate box First Name (Given) Middle Name Last (Family) Name
;
; ; ;
Organization: Position held: Postal address: City:
; ; ; ; ; Postal code:
; Country:
;
Tel: (international code - city area - number) Mobile: (international code - city area - number) Fax: (international code - city area - number) Email:
; ; ; ;
I’d like to use the preferential terms for joining WCFDavos summit on 10-11 March – please, send me the due information! -yes; -no Do you need a formal invitation for obtaining a visa: Type “x” in the middle of the appropriate box
-yes;
-no
Contact person (if different than the participant): ; Company position: ; Company name and address: ; Phone and email: ;