1. Complete name of the Company / Institution:

2. Commerce Registration Number :

3. Fiscal code:

4. Complete address (including phones, fax, e-mails, website):

5. Corresponding address:

6. Bank :

7. Bank address :

8. I will join the group that will visit on Sunday afternoon (October 31-St.) the Parliament House: Yes / No

The participation to the trip to the Parliament House (the second largest building in the world after Pentagon) is optional and will be paid/organized according to the number of participants. If you decide to join the group, please let us know in advance, including through this registration form.

9. To our booth will be present 1 / 2 persons that will have free entrance to the conference room.

10. Total number of people from our company/institution (people that will stay at the booth + supplemental co-workers):

11. The names of the people that will stay at the booth are:

....

....

12. In order to finalize our registration to the Api-Expo we already paid the total amount of ........ Eur, for:

- stand fee: ......

- suplemental co-workers from our company fees (40 Eur/person): ....

- "Romanian evening dinner" total fee (25 Eur/person): .....

- Post-congress total Workshop fees (90 Eur/person): .......

Please list here the names of people that will participate from your company to the "Romanian evening dinner":

Please list here the names of people that will participate to the post-Congress Workshop:

13. The payment was made by (name of institution / company or person that made the payment): .....................

for (name of company/institution): ...................... to the bank account of the Romanian Apitherapy Society.

Please send us all your answers to the above registration form, through a Word document, at: secretariat@apiterapie.ro