My name:
*
Keresztnév
Vezetéknév
WISE membership:
*
Please Select
Individual member
General member
Company member
Corporate member
I am not a member
membership relation
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My E-mail:
*
Payment method:
*
Please Select
1. Pls send invoice.
2. I pay by card.
3. I pay cash.
Payment
Company name:
*
Company name:
Address:
*
Address of the company
City:
*
City of your company
Country
*
Your country name
ZIP:
*
Zip code:
Fee for WISE members
*
Please Select
Until 12th of Nov. 99 €
Until 22th of Nov. 109 €
After 22th of Nov. 119 €
I am non WISE member.
Convention Fee:
*
Please Select
Until 12th of Nov 119 €
Until 22th of Nov 129 €
After 22th of Nov 139 €
I want to join to WISE.
Fee for Non-WISE members
I will bring my staff and friends:
Name1:
*
Coming with me
Name 2:
Coming with me 2.
Name 3:
Coming with me 3.
My contact details:
*
Mobile or landline
Company promotion, poster: - 50 EURO
*
Thank you, I will not.
Yes, I will put my poster.
Type of my card:
*
Please Select
Master
Visa
Card number:
*
Card number:
Expiry date:
*
NAme on the card:
*
Name on the card
SEND
Should be Empty: