Registration Form · Tel.: +49 341 678

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Registration Form

Please complete this document and send via fax to +49 341 678 8972. Personal Details: User-ID:* _____________________________________________________________________________________________ Title:*

Mr.

Ms.

Dr.

Prof.

First Name:*

_____________________________________________________________________________________________

Last Name:*

_____________________________________________________________________________________________

Organisation:* _____________________________________________________________________________________________ _____________________________________________________________________________________________ Position:* _____________________________________________________________________________________________ Street / Postbox:*

_____________________________________________________________________________________________

_____________________________________________________________________________________________ Post code / Zip code:*

_____________________________________________________________________________________________

City:* _____________________________________________________________________________________________ Country:* _____________________________________________________________________________________________ State / Province:*

_____________________________________________________________________________________________

Telephone*: _____________________________________________________________________________________________ Fax: _____________________________________________________________________________________________ Mobile phone:

_____________________________________________________________________________________________

Email:* _____________________________________________________________________________________________ Accompanying person (First name, Last name):

_____________________________________________________________________________________________

Participant Category:

Minister / Head of Delegation (0,00 EUR) Additional Member of Official Delegation (350,00 EUR) Accompanying person before 10 April (120,00 EUR)

Please select your preferred language:*

English

Specialisation:*

Automobile Cycling Aviation Pedestrian Other _____________________________

French

Member of Official Delegation (0,00 EUR) Accompanying person after 10 April (155,00 EUR)

German

Russian

Logistics/Freight Maritime/Waterways

Public transport Rail

The fields marked with * are mandatory.

[email protected] · Tel.: +49 341 678-6864 · Fax: +49 341 678-8972

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Networking events Presidency Reception hosted by the New Zealand Minister – Wednesday 27 May, Evening Gala Dinner – Thursday 28 May, Evening “Women in Transport“ Breakfast – Friday 29 May, 07:30 – 09:00

number of persons ____________ number of persons ____________ number of persons ____________

Technical Tour – Wednesday 27 May – Morning BMW – Wednesday 27 May, 09:00 – 10:30

number of persons ____________

Technical Tour – Wednesday 27 May – Evening DHL Airfreight Hub – Wednesday 27 May, 21:30 – 00:00 DHL Airfreight Hub – Wednesday 27 May, 22:00 – 00:30

number of persons ____________ number of persons ____________

Technical Tour – Thursday 28 May – Morning BMW – Thursday 28 May, 09:00 – 10:30 CargoBeamer – Thursday 28 May, 09:00 – 10:30

number of persons ____________ number of persons ____________

Technical Tour – Thursday 28 May – Lunchtime Porsche – Thursday 28 May, 13:00 – 15:00 BMW – Thursday 28 May, 13:00 – 15:00

number of persons ____________ number of persons ____________

Cultural programme – Friday 29 May Leipzig Walking Tour, 13:45 – 18:00 Guided Tour of Dresden, 13:30 – 20:00 Guided Tour of Berlin, 13:00 – 22:00 Cycling Tour within Leipzig, 13:30 – 16:00

60.00 EUR 125.00 EUR 170.00 EUR free

number of persons ____________ number of persons ____________ number of persons ____________ number of persons ____________

Hotels Number of nights ____________ at: The Westin Hotel 5 stars



Deluxe Room Single Deluxe Room Double Junior Suite Single Junior Suite Double

160.00 EUR 180.00 EUR 250.00 EUR 270.00 EUR

Grand Deluxe Room Single Double Room Grand Deluxe Full Suite Single Full Suite Double

190.00 EUR 210.00 EUR 280.00 EUR 300.00 EUR

The Radisson Blu Hotel 4 stars



Classic Room Single Classic Room Double Junior Suite Single Junior Suite Double

159.00 EUR 179.00 EUR 229.00 EUR 249.00 EUR

Executive Room Single Executive Room Double Full Suite Single Full Suite Double

199.00 EUR 219.00 EUR 259.00 EUR 279.00 EUR

Executive Room Single 210.00 EUR The Marriott Hotel 4 stars Classic Room Single 155.00 EUR Executive Room Double 220.00 EUR Classic Room Double 175.00 EUR Junior Suite Single (Studio) 230.00 EUR

Full Suite Single 360.00 EUR Full Suite Double 370.00 EUR Junior Suite Double (Studio) 240.00 EUR

The Seaside Park Hotel 4 stars Executive Room Single Classic Room Single 121.00 EUR Executive Room Double Classic Room Double 141.00 EUR Full Suite Single

141.00 EUR 161.00 EUR 205.00 EUR

Junior Suite Single Junior Suite Double Full Suite Double

185.00 EUR 195.00 EUR 215.00 EUR

InterCityHotel Leipzig 4 stars

Classic Room Single Classic Room Double

134.00 EUR 154.00 EUR

Executive Room Single Executive Room Double

144.00 EUR 174.00 EUR

Motel One Augustusplatz 2 stars

Classic Room Single

98.50 EUR

Classic Room Double

118.00 EUR

Motel One Niklolaikirche 2 stars

Classic Room Single

98.50 EUR

Classic Room Double

118.00 EUR

Additional requirements for your hotel booking: Smoking Accessible room requested

[email protected] · Tel.: +49 341 678-6864 · Fax: +49 341 678-8972

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Visa requirements: If you need a visa to enter Germany please fill in the information below in order to receive an invitation letter for visa purposes. Date of Birth: __________________________________________________ Passport Number: _________________________________________________ Passport Expiry Date: ____________________________________________ Indicate the city of the German Embassy / Consulate where you will apply for a visa _____________________________ Arrival:

Departure:

Date of Arrival: ___________________ Time of Arrival: ______________

Date of Departure:

Arrival at (city): ___________________

Departure from (city): _______________

Arrival by:

Airplane

Train

Other

Departure by:

_______________ Time of Departure: ______________

Airplane

Train

Other

Flight / Train Number: ______________________________________

Flight / Train Number: _________________________________________

I require a transfer from Leipzig / Halle airport by shuttle

I require a transfer to Leipzig / Halle airport by shuttle

yes

(free of charge):

no

(free of charge):

yes

no

Travel to Leipzig from other locations in Germany:



Deutsche Bahn Return Ticket (from any station in Germany to Leipzig) first class

69.00 EUR

number of persons ____________

Highspeed train from Berlin including transfers to/from Tegel or Schönefeld airports to Leipzig Hauptbahnhof, first class return ticket

69.00 EUR

number of persons ____________

Dietary requirements: Vegetarian Accessibility needs (please specify): _________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________

Payment by bank transfer Payment by credit card Credit card:

Visa

Mastercard

Amex

Card Verification Code (CVC)*:

Card number: * For Visa-, Mastercard also state the last three digits in the signature field on the back of the credit card, with Amex please indicated the four digits which are given on the front side of the card.

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Cardholder (First name, Last name, Address) –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Expiry date Legally binding signature

_______________________________________________________ Date

__________________________________________________________ Signature

[email protected] · Tel.: +49 341 678-6864 · Fax: +49 341 678-8972