ICCX Russia - Exhibitors registration form Step 1 of 5 Exhibition stand Stand details* Booth number* If possible we would like to change to booth number Company name for fascia panel* Website for exhibitor listing* Country for exhibitor listing* Afghanistan African Union Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Arab League Argentina Armenia Aruba Asean Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Caricom Cayman Islands Central African Republic Chad Chile China Cis Colombia Commonwealth of Nations Comoros Congo Brazzaville Congo Kinshasa Cook Islands Costa Rica Cote DIvoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Ecuador El Salvador England Equatorial Guinea Eritrea Estonia Ethiopia European Union Faroes Fiji Finland France Gabon Gambia Georgia Germany Ghana Gibraltar Greece Grenada Guam Guatemala Guinea Bissau Guinea Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonezia Iran Iraq Ireland Islamic Conference Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenshein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia NATO Nauru Nepal Netherlands Antilles Netherlands New Zealand Nicaragua Niger Nigeria North Korea Northern Cyprus Northern Ireland Norway Olimpic Movement Oman OPEC Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Romania Russian Federation Rwanda Saint Lucia Samoa San Marino Sao Tome and Principe Saudi Arabia Scotland Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Korea Spain Sri Lanka St Kitts and Nevis St Vincent and the Grenadines Sudan Suriname Swaziland Sweden Switzerland Syria Tahiti Taiwan Tajikistan Tanzania Thailand Timor Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United Nations United States of America Uruguay Uzbekistan Vanutau Vatican City Venezuela Vietnam Virgin Islands British Virgin Islands US Wales Western Sahara Yemen Zambia Zimbabwe Responsible person for placing the order* Email address* This person will receive the order confirmation and important information regarding the event. ICCX Sponsorship ICCX Sponsorship* None Platinum Sponsoring Package - 5.000 € Gold Sponsoring Package - 3.500 € Silver Sponsoring Package - 2.000 € Evening Event Sponsor - 3.000 € Plant Tour Sponsor - 1.500 € Your company logo on lanyard on press wall on badges at conference bag in conference room on ICCX Russia Website under CPI articles in advertisements 4 One day registration tickets incl. evening event Your company logo on badges at conference bag in conference room on ICCX Russia Website under CPI articles in advertisements 2 One day registration tickets incl. evening event Your company logo in conference room on ICCX Russia Website under CPI articles in advertisements Acknowledgement as Sponsor Venue decoration Opportunity for one gift/promotional item for each Guest of the function Sponsor logo is printed in the «Paulaner Restaurant» Organisation of busses to your plant Your company logo in conference room on ICCX Russia Website under CPI articles in advertisments Marketing Contact Person for Marketing Material* Shortly before the event we will send you a promotional material that you can easily forward either to your email contacts or to your WhatsApp contacts to invite your customers to the event. We will not use your email not your WhatsApp number for any other purposes than to provide you with customized marketing material for your company. Email address* Mobile number / WhatsApp number* Next step Step 2 of 5 Booth staff / Attendees 1st Attendee 1st Attendee - Title* Mr. Ms. Mrs. 1st Attendee - First name* 1st Attendee - Last name* 1st Attendee - E-Mail* 1st Attendee - Additional options ICCX Party at "PAULANER" (08.12) € 75,- Plant Tour (10.12.2021) € 50,- 2nd Attendee 2nd Attendee - Title Mr. Ms. Mrs. 2nd Attendee - First name 2nd Attendee - Last name 2nd Attendee - E-Mail 2nd Attendee - Additional options ICCX Party at "PAULANER" (08.12) € 75,- Plant Tour (10.12.2021) € 50,- Additional exhibition booth staff registration Additional booth staff requires separate registration that includes participation at the exhibition, a congress bag with information material, lunch and coffee breaks Additional Attendees None 1 2 3rd Attendee Price per person € 175,- 3rd Attendee - Title Mr. Ms. Mrs. 3rd Attendee - First name 3rd Attendee - Last name 3rd Attendee - E-Mail 3rd Attendee - Additional options ICCX Party at "PAULANER" (08.12) € 75,- Plant Tour (10.12.2021) € 50,- 4th Attendee Price per person € 175,- 4th Attendee - Title Mr. Ms. Mrs. 4th Attendee - First name 4th Attendee - Last name 4th Attendee - E-Mail 4th Attendee - Additional options ICCX Party at "PAULANER" (08.12) € 75,- Plant Tour (10.12.2021) € 50,- Previous step Next step Step 3 of 5 Billing information Company data Company* Homepage Street* Postal code* City* Country* Afghanistan African Union Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Arab League Argentina Armenia Aruba Asean Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Caricom Cayman Islands Central African Republic Chad Chile China Cis Colombia Commonwealth of Nations Comoros Congo Brazzaville Congo Kinshasa Cook Islands Costa Rica Cote DIvoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Ecuador El Salvador England Equatorial Guinea Eritrea Estonia Ethiopia European Union Faroes Fiji Finland France Gabon Gambia Georgia Germany Ghana Gibraltar Greece Grenada Guam Guatemala Guinea Bissau Guinea Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonezia Iran Iraq Ireland Islamic Conference Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenshein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia NATO Nauru Nepal Netherlands Antilles Netherlands New Zealand Nicaragua Niger Nigeria North Korea Northern Cyprus Northern Ireland Norway Olimpic Movement Oman OPEC Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Romania Russian Federation Rwanda Saint Lucia Samoa San Marino Sao Tome and Principe Saudi Arabia Scotland Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Korea Spain Sri Lanka St Kitts and Nevis St Vincent and the Grenadines Sudan Suriname Swaziland Sweden Switzerland Syria Tahiti Taiwan Tajikistan Tanzania Thailand Timor Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United Nations United States of America Uruguay Uzbekistan Vanutau Vatican City Venezuela Vietnam Virgin Islands British Virgin Islands US Wales Western Sahara Yemen Zambia Zimbabwe VAT-ID. (only EU) Contact person for invoice Title* Mr. Ms. Mrs. Dr. Prof. First name* Last name* Phone* Fax Email address* Remarks (500 chars left) Previous step Next step Step 4 of 5 Payment Payment type* Invoice Credit card name* Visa Mastercard American Express Card number* CVC2/CVV2* Valid until* 01/2018 02/2018 03/2018 04/2018 05/2018 06/2018 07/2018 08/2018 09/2018 10/2018 11/2018 12/2018 01/2019 02/2019 03/2019 04/2019 05/2019 06/2019 07/2019 08/2019 09/2019 10/2019 11/2019 12/2019 01/2020 02/2020 03/2020 04/2020 05/2020 06/2020 07/2020 08/2020 09/2020 10/2020 11/2020 12/2020 01/2021 02/2021 03/2021 04/2021 05/2021 06/2021 07/2021 08/2021 09/2021 10/2021 11/2021 12/2021 01/2022 02/2022 03/2022 04/2022 05/2022 06/2022 07/2022 08/2022 09/2022 10/2022 11/2022 12/2022 01/2023 02/2023 03/2023 04/2023 05/2023 06/2023 07/2023 08/2023 09/2023 10/2023 11/2023 12/2023 General Terms & Conditions Our general terms and conditions apply. General Terms and Conditions of Business for Exhibitors of ad-media GmbH Do you accept the general terms and conditions?* I have read the general terms and conditions and I accept them. Privacy policy The privacy policy can be found here. Consent* I agree that we are allowed to use your email address for the purpose of sending you our newsletters. You can revoke your permission anytime in the future via email address This email address is being protected from spambots. You need JavaScript enabled to view it.. After processing, your data will be deleted. Detailed information pertaining to the handling of user data can be found in our data protection declaration . Previous step Next step Step 5 of 5 Summary Stand details Booth number If possible we would like to change to booth number ICCX Sponsorship Company name for fascia panel Country for exhibitor listing Responsible person for placing the order Email address Contact Person for Marketing Material Email address Mobile number / WhatsApp number 1st Attendee's title 1st Attendee's first name 1st Attendee's last name E-Mail 1st additional options 2nd Attendee's title 2nd Attendee's first name 2nd Attendee's last name 2nd additional options E-Mail Additional Attendees 3rd Attendee's title 3rd Attendee's first name 3rd Attendee's last name E-Mail 3rd additional options 4th Attendee's title 4th Attendee's first name 4th Attendee's last name E-Mail 4th Additional options Company Homepage Street Postal code City Country Contact person for invoice Title First name Last name Phone Fax Email VAT-ID. (only EU) Payment type Remarks Do you accept the general terms and conditions? Captcha Previous step Order with obligation to pay Information Your ICCX Russia registration has been submitted successfully! We will check your registration and send you a confirmation email. Please click here to get to the start page. Please turn on javascript to submit your data. Thank you!
