MEDIA/TECHNOLOGY Supplier Online Registration
September 22, 23 & 24, 2010

Lima, Peru - Real Felipe Fortress

 

All online registrations are subject to final review and confirmation by William H. Coleman, Inc.

   

Company Information
Please this registration form as you want the information to appear on your Media credentials.

Company/Publication Name:

Delegate Name:

Job Title:

Mailing Address:

City/State:

Country/Postal Code:

Telephone:

Please include the country code and city code, and/or area code, where applicable.

Fax:

Email:

Website:

Please provide general information about your company.
(Limited to about 45 words):

NEW: ONSITE UPDATES

If you would like to receive text message updates onsite in Lima, please provide us your cellular telephone number. 
NOTE: This information you provide is confidential for use by WHC, Inc. and only for the purpose of providing onsite updates.

Registration Fees

Your registration fee includes: One Delegate; additional delegate is $225.00; a Table-Top during the Marketplace on September 24 and 25, chairs, sign, Official Directory of Services, Meeting Guide/Appointment Book; Transfers on official arrival and departure days; and attendance at official social functions. Special airfares are offered by participating airlines serving Chile. Airline reservations and ticketing information is provided to all registered and confirmed delegates.

1 Media Table-Top @ $2,000 USD.
Includes: One delegate, one Table-Top, up to four chairs, and a sign.  

Number of Additional Delegates to register @ $225 USD per delegate.
 

Additional Delegate Name
First/Last Name/Job Title

Additional Delegate Name
First/Last Name/Job Title

PLEASE NOTE: Media/Technology Suppliers are provided a Table-Top during the event which is located on the Marketplace business floor or Cafe area.  If you would like to request a stand (3m x 2m) there is an additional charge of $1000 USD.  Stands are limited.  Please check below if you would like to request a stand.

  Yes, we would like to request a stand.
      (an additional charge of $1000 USD will apply is stands are available)

 

Choose Payment Method:

Company Check (must be sent by courier)

Money Order (must be sent by courier)

Wire Transfer (Add US$10.00 processing fee)

Credit Card 

Confirmation Letter Method:   

Terms of Agreement

Please read the TERMS OF AGREEMENT and check-off. Form will not be submitted unless the box marked "Yes" is checked:

  I agree with the terms above

Name:

 

Date:

 

Form Submission

TravelMart LatinAmerica 2010. After submission, you will be given the payment options and about 48 hours later, an Email or fax response will be sent to you.

Please note that all registrations are not confirmed until all fees have been paid and qualifications have been verified.  If you are interested in any sponsorship opportunities, please contact us at sales@whcoleman.com