Reference Number: 32926443Name: Michel louis claud

Houbaille
Email: michelhoubaillemonlanthaut@gmail.com
Company: Monlanthaut.fr
Title: Écrivains
Address: Rue vivegnis
City: Liège
State: New York
State/County/Province: Belgique
Country: Belgium
Postal Code: 4000

Event: 2018 IAPP Data Protection Intensive: DeutschlandDates: 18/09/2018

- 19/09/2018

Selection Quantity Cost

Michel louis claud Houbaille: Delegate 1 €0.00
Public Sector 1 €445.00
Please select one of the Programmes : English Programme 1 €0.00

Event Fees: €445.00

HST%: €0.00
Total: €445.00
Amount Paid: €0.00

Registration fees are not refundable but are transferable to a person in the same company, pending IAPP approval. No
refunds if you cancel or don’t show-up. Your completed registration form, online registration and email confirmation
constitute binding agreement between two parties.

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 Net €445.00
Paid €0.00
Balance €445.00

PAYMENT

Payment must accompany your registration form.

Please send payments to:

International Association of Privacy Professionals
75 Rochester Ave., Suite 4
Portsmouth, NH 03801 USA

Enclosed is check #___________ in amt. of $____________

• ALL registrants: Please make check payable to IAPP

• Please write attendee’s name on check

Credit card: Charge $__________________ to the following:

Visa MasterCard American Express Discover

Card number: _____________________________________

Expiration date: ___________________________________

Cardholder’s name: _________________________________

Cardholder’s signature: ______________________________

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