Sponsorship and Exhibition
Please fill up the Sponsor Entry Form on-line or download the form in .pdf or .doc format :
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June 05 – 08, 2014, Sopot, POLAND
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The 12th 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 € |
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□ Gold |
15’000 € |
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□ Silver |
10’000 € |
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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 € |
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□ Gala Dinner |
17’000 € |
Program Advertisement | ||||
□ Conference Bags |
6’800 € |
□ Full page – inside front cover |
900 € |
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□ Conference Notepads |
1’000 € |
□ Full page – back cover |
900 € |
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□ Conference Pens |
800 € |
□ Full page – inside publication |
600 € |
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□ Insert Sponsor’s promotional item into delegates bags |
1’200 € |
□ Half page – inside publication |
300 € |
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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
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Title |
First Name |
Last Name |
Congress Fee |
Congress Hotel 155,00 € room/night |
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1. |
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□ 620,00 € |
□ 5/06 |
□ 6/06 |
□ 7/06 |
□ 8/06 |
2. |
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□ 620,00 € |
□ 5/06 |
□ 6/06 |
□ 7/06 |
□ 8/06 |
3. |
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□ 620,00 € |
□ 5/06 |
□ 6/06 |
□ 7/06 |
□ 8/06 |
4. |
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□ 620,00 € |
□ 5/06 |
□ 6/06 |
□ 7/06 |
□ 8/06 |
5. |
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|
□ 620,00 € |
□ 5/06 |
□ 6/06 |
□ 7/06 |
□ 8/06 |
TOTAL |
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TOTAL PAYMENT FOR INVITED LECTURERS:
NET € |
23% VAT |
SPONSORS / EXHIBITORS ACCOMODATION
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Title |
First Name |
Last Name |
Congress Hotel 155,00 € room/night |
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1. |
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□ 5/06 |
□ 6/06 |
□ 7/06 |
□ 8/06 |
2. |
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□ 5/06 |
□ 6/06 |
□ 7/06 |
□ 8/06 |
3. |
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□ 5/06 |
□ 6/06 |
□ 7/06 |
□ 8/06 |
4. |
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□ 5/06 |
□ 6/06 |
□ 7/06 |
□ 8/06 |
5. |
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□ 5/06 |
□ 6/06 |
□ 7/06 |
□ 8/06 |
TOTAL |
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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 € |
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2 + ….. = ….. | 1 + ….. = ….. | ||||
OPTION II standard booth
|
No. of sqm |
sqm x price 260,00 € |
23% VAT |
chair /4 incl./ |
table /1 incl./ |
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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 |
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SOPOCKIE CENTRUM KONFERENCYJNE | |
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PL 33 1050 1764 1000 0090 9547 4897 | |
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ING Bank Śląski S.A. | |
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INGBPLPW | |
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81-805 Sopot, al. Niepodległości 786 | |
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+48 58 522 89 00 |
Date: ____________________________
By: ____________________________ Title: ___________________________