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