INSME Association Member registration form_15feb by liwenting

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									               INSME MEMBER
             REGISTRATION FORM



       6th INSME Annual Meeting 2010
“SME Innovation: boosting development and
             Growth in times of change”

                  Rio de Janeiro – Brazil
                           10-13 May, 2010


                     Sofitel Copacabana
                 Av. Atlântica 4240 - Copacabana



Please send this registration form by e-mail or fax by April 30th, 2010 to:

              INSME - International Network for SMEs
                        INSME Secretariat

                                c/o IPI
                        Viale M. Pilsudski, 124
                         00197 Rome – Italy
                       Fax: +39 06 80972443
                    E-mail: insmerio2010@insme.it
              Website: www.annualmeeting2010.insme.org
Please fill in, in capital letters, the fields below with the relevant information:


□   Mr.      □   Mrs.      □   Miss     □   Dr.         □   Prof.


First Name: ______________________________________________________


Last Name: ____________________________________________________________


Organisation Name: ______________________________________________________


Title/Position within your organisation: ____________________________________


_______________________________________________________________________


Address:_______________________________________________________________


_______________________________________________________________________


City Code: _____________                City: __________________________________


Country: _______________________________________________________________


Telephone No.*: _________________________________________________________


Fax*: __________________________________________________________________


E-mail: _________________________________________________________________


Website: http://___________________________________________________________


Date of arrival in Rio: ___ / ___                 Date of departure from Rio: ___ / ___

Do you require a visa to enter in Brazil?           □ yes           □ no

Signature
____________________________________________________________




*
 Please, type telephone and fax numbers as they should be dialled from outside your own
country – including country and city prefixes

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I am an INSME Member and I would like to attend the INSME 2010 Annual Meeting on the
following days:

      Monday, May 10, 2010

            Institutional Thematic Round Tables will be available on the morning of May
             10th, for free and upon pre-booking, for those INSME Members interested in
             discussing with Brazilian organizations and other international delegates about
             selected themes. The Institutional Round tables aim to provide a specific
             moment and a meeting room for matchmaking, where participants will have the
             opportunity to discuss and make presentations about their institutions, projects
             and potential partnerships among other delegates. Two rooms will be equipped
             with audiovisual facilities for a maximum audience of eight people. In case that
             you are interested in booking an institutional meeting and/or making a
             presentation during a round table (duration about one hour), please indicate
             your expression of interest below. We will analyze your demand and search for
             possible matches, accordingly to the availability of counterparts. The INSME
             Secretariat will contact you soon in this regard to follow up. Please acknowledge
             that INSME can not guarantee that a matching institution or individuals will be
             found accordingly to your demand.
             □   yes       □   no

             Topic for the Roundtable:____________________
             Duration:____________________

             Attach an abstract if you can.

            Sixth INSME Association General Assembly (afternoon)
             □   yes       □   no

            Opening ceremony and Welcome Cocktail
             □ I will attend        □ The person accompanying me will attend
                                    His/her full name is:____________________
             Please tick the box if you would like to request a vegetarian meal
             □ Myself               □ The person accompanying me
      Tuesday, May 11, 2010

            International Conference on “SME Innovation: boosting development and
             Growth in times of change” (morning and afternoon)
             □   yes       □   no

            Welcome dinner
             □ I will attend        □ The person accompanying me will attend
                                    His/her full name is:____________________
             Please tick the box if you would like to request a vegetarian meal
             □ Myself               □ The person accompanying me
      Wednesday, May 12, 2010

            International Conference on “SME Innovation: boosting development and
             Growth in times of change” (morning)
             □   yes       □   no


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                 Industrial site visit to Rio Tech Park (afternoon)
                  □ I will attend            □ The person accompanying me will attend

                 Cultural and social visit to the Rio City Hall (late afternoon - early evening)
                  □ I will attend            □ The person accompanying me will attend

         Thursday, May 13, 2010

                 Rio City Tour (morning)*
                  □ I will attend            □ The person accompanying me will attend

* Note: Participation in the Rio City Tour is optional and on a fee basis to all participants.
INSME Delegates willing to participate at Rio City Tour shall contact directly the Tour Desk that
will be available at the Conference’s venue in order to schedule Rio site visits.


Notes:
1 . See list of recommended hotels - ANNEX I – for your reservation
2. Check about Visa requirements in time with the Brazilian Embassy in your country




                     NOTICE TO THE EFFECT OF LEGISLATIVE DECREE NO. 196/2003

Following to the requirements stated by art. 13 of the Legislative Decree no. 196 of June 30, 2003, on “Personal Data
Protection Code” (following: the “Code”), we would inform you that your personal data are/will be processed by the
INSME Association, with respect to the applicable law, exclusively for the aims related to its purposes and to consider
your application for participation in the INSME Association meeting, by manual instruments as well as informatic and
telematic, and oriented to the purposes above as to respect the safety and the confidentiality of the processed data. In
relation to your personal data, we inform you, that art. 7 of the Code, recognises to you, in the quality of data subject,
specific rights, among which the right to obtain the updating, rectification or, where interested therein, integration of the
data. The Controller in charge of your data processing, will be the INSME Association, having its registered office in
Rome, c/o IPI, Viale M. Pilsudski, 124, 00197 Rome – Italy.




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                                       ANNEX I
Transportation from the airport to the hotels and vice versa will be provided by the organizers
upon previous communication regarding the flight schedules.

The INSME Secretariat cannot take care of your hotel booking. Please contact the hotels directly
and in time. Normally a credit card number is requested to make the reservation.




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