Arab Luxury World 2015

Arab Luxury World 2015
Delegate Confirmation Form for Conference & ALW App
Please complete the below form and mail back to Mediaquest Corp
Fields marked with * are mandatory, also sign & send the form across to us
Title *: Mr. Ms. Mrs.
Full Name*: _________________________________________________________
Preferred name for delegate badge*: ______________________________________
Company/Association*: _________________________________________________
Job Title*:_____________________________________________________________
Office Telephone: _______________________________
Mobile*: _______________________________________
Country of Residence: ____________________________
Email *: ________________________________________
Please provide the following information which will be included in the ALW App. The
information will appear exactly the way it is provided to us.
Biography
Please highlight your achievements, career and education in less than 80 words.
nd
P.O Box 72184 Dubai Media City, ZEE Tower Bldg, 2 Floor, Office # 206
Tel: 00971 4 369 75 73 / Fax: 00971 4 390 87 37
Company Description and line of business in less than 50 words.
A portrait picture of you that would need be a hi-resolution jpeg format image
(Dimension 200 x275 px)
I give permission to Mediaquest Corp. to share my bio and picture on Arab Luxury World /
Luxury mena app, collateral where it will be available for Public viewing.
 Yes  No
I give permission to Mediaquest Corp. to post my photo on the Arab Luxury World, Luxury
mena app, event collateral where it will be available for Public viewing.
 Yes  No
Please provide your contact details to be shared on app, website that you want the other
delegates to be able to view.
Telephone: ________________________________________________________________
Email: ______________________________________________________________
nd
P.O Box 72184 Dubai Media City, ZEE Tower Bldg, 2 Floor, Office # 206
Tel: 00971 4 369 75 73 / Fax: 00971 4 390 87 37
CONFERENCE FEES
A. For two-day delegate pass:
 Standard registration fees – $ 1,100 per delegate
B. For one-day delegate pass:
 Standard registration fees – $ 700 per delegate
PAYMENT METHOD
Payment currency: US Dollars/ UAE Dirhams
Conversion rate: 3.67
 Cash
 Cheque/Draft (payable to Medialeader FZ LLC)
 Bank Transfer to A/c No.: AED 035 321009 001
US$ - 035 321009 100
Euro – 035 321009 101
IBAN AED – AE350200000035321009001
IBAN USD – AE780200000035321009100
IBAN EUR – AE510200000035321009101
Bank: HSBC Bank Middle East Limited,
Jebel Ali Branch, PO Box 66, Dubai - UAE
Swift Code: BBMEAEAD.
*Bank charges should be borne by the client only.
 Online: http://mediaquestcorp.com/single-payment/
o Mastercard
o Visa
TERMS & CONDITIONS
1.
Payment terms: Following completion and return of the registration form, full payment is
required within 7 working days from receipt of invoice.
PLEASE NOTE: Payment must be received prior to the conference date. Due to limited
conference space, we advise early registration to avoid disappointment. Mediaquest reserves
the right to refuse admission if payment is not received on time.
2. Substitution: Provided the total fee has been paid, substitutions at no extra charge up to 1 week
prior to the event are allowed.
3. Cancellation: In case of cancellations, request must be received in writing by mail or fax within one
week from the date of registration of which the fee will then be refundable. After one week of
registration, any cancellation made will be non-refundable. Non-attendance does not constitute
cancellation.
4. Copyright: All intellectual property rights in all materials produced or distributed by Mediaquest
Corp in connection with this event is expressly reserved and any unauthorized duplication,
publication or distribution is prohibited.
nd
P.O Box 72184 Dubai Media City, ZEE Tower Bldg, 2 Floor, Office # 206
Tel: 00971 4 369 75 73 / Fax: 00971 4 390 87 37
5. Important note: While every reasonable effort will be made to adhere to the advertised package,
Mediaquest Corp reserves the right to change event dates, sites or location as it deems necessary
without penalty and in such situations no refunds, part refunds or alternative offers shall be made.
The client acknowledges that they have read and understood all terms and conditions of this contract.
Authorisation:
This booking is invalid without a signature.
Signature(s) *: ______________________ Date:
 /  / 
nd
P.O Box 72184 Dubai Media City, ZEE Tower Bldg, 2 Floor, Office # 206
Tel: 00971 4 369 75 73 / Fax: 00971 4 390 87 37