Principal Sponsor

11.11.13- Daniel Herzliya Hotel

Registration Form
To register for the conference, kindly print and fax completed form to: (03) 9247783
Name: Title:

:
Company : Address: Invoicing Address: Cellular: Telephone: Name of signatory: Email: Fax: Telephone of signatory: Reg.# (..):

City:
City:

Zip: Zip:

Price for the Conference day- only 210 NIS + VAT

Attendees will be entered in a raffle for a valuable prize.

Pay by:

Check

Transfer

Credit Card

For Credit Card payment, please fill in: Check one:

Visa MasterCard American Express Other, specify: _________________

Card holder name: _____________________ Card holder address: _________________________ Card holder phone: _____________________ Card Number: _______________________________ Expiration date: ___________ (mm/yy) Holders ID Card number: __________________________

Company Stamp
Terms of Registration: Due Payment: has to be done before the event. Terms of canceling participation: up to 7 days before the conference: no charge. Up to 3 days before the conference: 30% of the price will be charged. Two days before the conference: a full price will be charged.

Signature

This Registration constitutes your agreement to accept technology-related mails from Logtel. Please check the box if you disagree.
To register and send payments please write, call or fax: Liran Grushka: liran@logtel.com Tel: 03-924 7780 # 107 - Fax: 03-924 7783 - 32 Shaham St., Petah Tikva, 49170, Israel
Main Sponsor: Sponsors:

Schedule and tracks subject to change. Should, for any reason, the event be rescheduled or cancelled, the extent of our liability is limited to the return of fees paid to us.