CONFERENCE REGISTRATION FORM by JaymesChapman

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									                                       CONFERENCE REGISTRATION FORM
                                       2010 SPE/IADC Managed Pressure Drilling &
                                    Underbalanced Operations Conference & Exhibition

                               24-25 February 2010, Shangri-La Hotel, Kuala Lumpur, Malaysia




                                    Online registration is available at:
                               http://www.iadc.org/conferences/MPD_UBO
                   Please complete the entire form. Duplicate this form for additional registrants.
 Mr./Ms.       First (Forename) Name                 Mid. Init.      Last (Family) Name


 Name to be printed on your badge                                 Job Title



 Company


 Office Address / PO Box


City                                                                             State     Zip/Postal Code


Country                                    E-Mail Address (IMPORTANT: Please complete so IADC can forward the conference proceedings)


Office Telephone                                                  Office Fax


Fee Information        Cancellations are subject to a US $ 25 processing fee. No refunds for cancellations after
                       23 January 2010.

                                    Registration Fee:                            US $ 850,-
Payment Information Cheques, money orders, wire transfers, or credit cards are acceptable.
        Payment must be made prior to the conference. All credit card payments will be charged in US Dollars.
                  * A processing fee of US $ 25 must be included for all wire transfer payments.

       Payment Enclosed             American Express               MasterCard                      Visa               Wire Transfer*
                                                                                                                 *Complete Form on Back


Credit Card Number:                                                                               Expiry Date:



Cardholder Name:                                                  Signature:




Credit card registrations: Fax to IADC at +31/24-3600759 (Netherlands) or +1/713-292-1946 (US)
Checks: Mail checks to IADC, PO Box 1430, 6501 BK, Nijmegen, The Netherlands
Door registrations: Payments may be made at the door in US Dollar $ 850
For more information, call IADC                          The Netherlands - Anne Otten at +31/24-6752252.
                                                         US – Leesa Teel at +1/713-292-1945
       IADC USE ONLY – MP0                   CID NO.                                   PID NO.
                                    WIRE TRANSFER FORM
                             2010 SPE/IADC Managed Pressure Drilling &
                         Underbalanced Operations Conference & Exhibition

                       24-25 February 2010, Shangri-La Hotel, Kuala Lumpur, Malaysia




        Please include a US $ 25 processing fee for all wire transfer payments.
Date:

Name:

Company Name:

Bank Issuing:

Amount:

Confirmation Number:

Wire Transfer Information:        IADC, the Netherlands
                                  Rabobank Nijmegen, PO Box 144, 6500 AC Nijmegen,
                                  the Netherlands
                                  Acct. Name: In-Act, inzake I.A.D.C. Netherlands
                                  Acct. No. 1358.53.206
                                  Bankcode 1378
                                  Swiftcode: RABONL2U
                                  Ibannumber: NL38RABO0135853206
                                  VAT: 165080899B01
Fax to IADC, 31/24-3600759 (Netherlands) or 1/713-292-1946 (US)

For additional registrations, please duplicate this form.




   Please assist us in tracking your payment by including the
  conference registrant’s name and referencing “MP0” on your
                         bank draft form.



  If you have a special physical or communication need that may impact your participation in
  any of these activities, please contact Anne Otten at phone:+31/24-6752252/ fax:+31/24-
  3600759 or Leesa Teel at phone:+1/713-292-1945 ext 210/fax:+1/713-292-1946.

								
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