Sponsorship and Exhibition

Please fill up the Sponsor Entry Form on-line or download the form in .pdf or .doc format :

June 05 – 08, 2014, Sopot, POLAND

 The 12^th Congress of the European Academy of Paediatric Dentistry

 EAPD Sponsorship Application Form

Company Profile	Company Name:
	Trade name to be used in all exhibition publication:
	Street:
	Postal code, City:		Country:
	Person in charge:		Position:
	EU VAT Number / NIP:
	Company Registration Number:		Website:
	Name of contact person:
	Phone:		Mobile Phone:
	E-mail:		Fax:
Level of Sponsorship	□    Platinum	20’000 €
	□    Gold	15’000 €
	□    Silver	10’000 €
Individual Sponsorship Items	□    Lunch & Learn	6’800 €	□   Friday	□   morning
	□    Coffee Break (per break)	3’400 €	□   Saturday	□   afternoon
	□    Welcome Drinks Reception	8’800 €	□   Badge Sponsorship		1’800 €
	□    Gala Dinner	17’000 €	Program Advertisement
	□    Conference Bags	6’800 €	□   Full page – inside front cover			900 €
	□    Conference Notepads	1’000 €	□   Full page – back cover			900 €
	□    Conference Pens	800 €	□   Full page – inside publication			600 €
	□    Insert Sponsor’s promotional  item into delegates bags	1’200 €	□   Half page – inside publication			300 €

 

INVOICING DATA   (Please fill in only if the payee different from given above)	Company Name for invoice:
	EU VAT Number / NIP:
	Company Registration Number:
	Street:
	Postal code, city, country:
	Phone:	Mobile Phone:
	E-mail:	Fax:

 

EXHIBITOR / STAND CONSTRUCTOR:

Name:	Contact person:
Contact details, phone, e-mail:

 

IDENTIFICATION BADGES /in Sponsorship Package – 2 ID badges are included; in one Exhibition stand – 1 ID badge is included/:

1.

2.

3.

4.

5.

6.

 

ADDITIONAL IDENTIFICATION BADGES

We hereby order ……………additional entry badges at the price of 160,00 € + 23% VAT = ………………….  €

 

INVITED LECTURERS

	Title	First Name	Last Name	Congress Fee	Congress Hotel 155,00 € room/night
1.				□   620,00 €	□ 5/06	□ 6/06	□ 7/06	□ 8/06
2.				□   620,00 €	□ 5/06	□ 6/06	□ 7/06	□ 8/06
3.				□   620,00 €	□ 5/06	□ 6/06	□ 7/06	□ 8/06
4.				□   620,00 €	□ 5/06	□ 6/06	□ 7/06	□ 8/06
5.				□   620,00 €	□ 5/06	□ 6/06	□ 7/06	□ 8/06
TOTAL

 

TOTAL PAYMENT FOR INVITED LECTURERS:

NET  €	23% VAT

 

SPONSORS / EXHIBITORS ACCOMODATION

	Title	First Name	Last Name	Congress Hotel 155,00 € room/night
1.				□ 5/06	□ 6/06	□ 7/06	□ 8/06
2.				□ 5/06	□ 6/06	□ 7/06	□ 8/06
3.				□ 5/06	□ 6/06	□ 7/06	□ 8/06
4.				□ 5/06	□ 6/06	□ 7/06	□ 8/06
5.				□ 5/06	□ 6/06	□ 7/06	□ 8/06
TOTAL

 

TOTAL PAYMENT FOR SPONSORS / EXHIBITORS ACCOMODATION:

 

NET  €	23% VAT

 

EXHIBITION AREA

We hereby order :

 

OPTION I area	No. of sqm	sqm x price 180,00 €	23% VAT	chair /2 incl./	table /1 incl./	AMOUNT in €
				2 + ….. = …..	1 + ….. = …..
OPTION II standard booth	No. of sqm	sqm x price 260,00 €	23% VAT	chair /4 incl./	table /1 incl./
				4 + ….. = …..	1 + ….. = …..

 

SOCIAL EVENTS /in Sponsorship Package – 2 tickets to all events are included/:

Gala Dinner

We hereby order ……………invitation/s at the price of 70,00 € + 23% VAT = ………………….  €

 

Get together Party

We hereby order ……………invitation/s at the price of 50,00 € + 23% VAT = ………………….  €

 

TOTAL PAYMENT:

Total value /sponsorship + ID badges + invited lecturers + accommodation + exhibition area + social events/

 

NET  €	23% VAT

 

 

Payment Schedule & Information	50% of total amount due before	50% of total amount due on or before
	Payment Method: WIRE TRANSFER IN € ONLY
	·       Account Holder:	SOPOCKIE CENTRUM KONFERENCYJNE
	·       € Bank Account:	PL 33 1050 1764 1000 0090 9547 4897
	·       Bank Name:	ING Bank Śląski S.A.
	·       Bank SWIFT Code:	INGBPLPW
	·       Bank Address:	81-805 Sopot, al. Niepodległości 786
	·       Contact Phone:	+48 58 522 89 00

 

Date:    ____________________________

 

By:       ____________________________               Title:     ___________________________