Registration Form

To register for the conference, please send signed and completed form by E-mail (itay@logtel.com) or
fax (03-9247783)

Name:

Title:
:

Company:

Reg.# ).(:

Address:

City:

Cellular:

Email:

Telephone:

Fax:

Name of signatory:

Telephone of signatory:

Zip:

Price for the congress day- only 620 NIS + VAT

Pay by: Check
Transfer Credit Card
Attendees will be entered in a raffle for a valuable prize.
For Credit Card payment, please fill in:
Check one: Visa MasterCard American Express Other, specify: _________________________
Card holder name: _____________________ Card holder address: ______________________________
Card holder phone: _____________________ Card Number: ___________________________________
Expiration date: ___________ (mm/yy) Holders ID card number: ______________________________

Company Stamp

Signature

Terms of Registration:
Due Payment: has to be done before the event.
Terms of canceling participation: up to 7 days before the congress: no charge.
Up to 3 days before the congress: 30% of the price will be charged.
Two days before the congress: a full price will be charged.
This Registration constitutes your agreement to accept technology-related mails from Logtel.
Please check the box if you disagree.
To register and send payments please write, call or fax to Itay Arie: Itay@logtel.com
Tel: 972-3-924 7780 # 109 - Fax: 03-924 7783 - 32 Shacham St., Petah Tikva, 49170, Israel

Platinum Sponsors:

Sponsors:

Schedule and tracks are subject to change.

Should, for any reason, the event be rescheduled or cancelled, the extent of our liability is limited to the return of fees paid to us.