First Name:

Last Name:

Position/Title:

Organisation:

Address:

Street:

City:

Country:

Postcode:

Telephone:

Fax:

Email: * (required)

Type of organisation :

Local/Regional Authority
National Government
European Institution
Telecom/Network Operator
IT Provider
Software House
Consultancy Company
Research/University
Other

Yes, I would like to participate with a stand at the exhibition.

Name of the stand:

Date:

Signature: