Conference Registration Form

Conference Pricing
Full
1 Day Pass $445.00
Government/ Military / Academics* $222.50
2 Day Pass $695.00
Government/ Military / Academics* $347.50
3 Day Pass $895.00
Government/ Military / Academics* $447.50

*Discounts for Exhibitors / Government / Military / Academics and Students. To apply for the discount code, email your credentials to: info@spacetechexpo.com

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 Your Details
(*required fields)  
     
Salutation
First Name (in full) *
Family Name (in full) *
Job Title *
Company Name *
     
     
 Additional details
 
Company's primary business activity *
(other Business activity)
Job Title Category? *
(other Job Title)
     
 Contact Details
Country *
Address *
   
Department/Mailcode  
Town or city
*
State *
Postal Code / Zip *
Telephone * -
Fax   -
Email *
 
 Visa Invitation Letter
I will require a Visa Invitation letter

If you have not had a reply to your Visa invitation letter request within seven days, please email info@spacetechexpo.com.

 Conference Pass - (Please select a day pass below)
Three-day delegate pass
Two-day open delegate pass
One-day delegate pass

 Please select the day you will be attending
Tues 19 May 2015
Wed 20 May 2015
Thurs 21 May 2015
Your Order Details
Order Total
Tax - 0%
Grand Total - US$
 
 Do you have a discount code for this conference?
Enter in the box on the right and click on "Apply Code"
 Your Payment Method - (Please select one)
* Pay by credit card NOW
 Your Payment Details
(* required fields)
Card Type: * From Date:
/ (mm/yy)
Card Number: * Expiry Date
*
/ (mm/yy)
Cardholder Name: * Issue Number: (Switch only)  
Security Code: * Where is the Security Code?
   
 Billing Address
(*required fields)
     
Tick this box if your billing address is the same as your Contact Address given above. Fields can be amended if required.
     
Billing Name * Town/City *  
Billing Company * State    
Country * Postal Code/Zip *  
Address * Telephone *  
    Email *  
           
 
Where did you hear about this event?
Where did you hear about this event? * if other, please specify
     
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