Online Registration

Company Name*:
Invoice Address*:
City*:			Post Code*:
Country*:
Tel:			Fax:

Your Personal Details (we value your privacy)

Title:	Mr Ms Mrs Dr Prof
First Name*:
Last Name*:
Job Title*:
Yrs of Mgt Exp.*:
Email*:
Email PA (optional):
Direct Tel*:			Mobile Phone:*

(*required fields)

Select Your Course

Please tick which programme you want to register for:

Title	Code	Price*
Essentials of Pharmaceutical Pricing
1-2 March 2012, Brussels	PRI-12	€2.970
24-25 May 2012, Copenhagen	PRI-13	€2.970
18-19 September 2012, Madrid	PRI-14	€2.970
6-7 December 2012, Brussels	PRI-15	€2.970
The Digital Pharma Marketing Course
6-7 March 2012, Brussels	DIG-06	€2.970
22-23 May 2012, Copenhagen	DIG-07	€2.970
20-21 September 2012, Madrid	DIG-08	€2.970
27-28 November 2012, Brussels	DIG-09	€2.970
The Pharma Business Development Course
8-9 March 2012, Brussels	PBD-19	€2.970
4-5 June 2012, Zurich	PBD-20	€2.970
4-5 October 2012, Brussels	PBD-21	€2.970
12-13 December 2012, London	PBD-22	€2.970
The Pharma Brand Planning Course
12-13 March 2012, Madrid	PBP-18	€2.970
11-12 June 2012, Istanbul	PBP-19	€2.970
15-16 October 2012, Brussels	PBP-20	€2.970
10-11 December 2012, Brussels	PBP-21	€2.970
Health Economics for Non-Health-Economists
14-15 March 2012, Madrid	HEC-08	€2.970
13-14 June 2012, Brussels	HEC-09	€2.970
27-28 September 2012, Copenhagen	HEC-10	€2.970
3-4 December 2012, Brussels	HEC-11	€2.970
Pharma-Biotech Product & Company Valuation
18 March 2012, Amsterdam	VAL-12	€1.470
24 October 2012, Zurich	VAL-13	€1.470
The Pharma Forecasting Course
20-21 March 2012, Brussels	FOR-20	€2.970
6-7 June 2012, Zurich	FOR-21	€2.970
2-3 October 2012, Brussels	FOR-22	€2.970
10-11 December 2012, London	FOR-23	€2.970
The Pharma Market Access Course
17-18 April 2012, Brussels	ACC-09	€2.970
25-26 September 2012, Copenhagen	ACC-10	€2.970
4-5 December 2012, Brussels	ACC-11	€2.970
Late Stage Pharma Lifecycle Management
19 April 2012, Brussels	LCM-11	€1.470
20 November 2012, Brussels	LCM-12	€1.470
The Pharmaceutical Out-licensing Course
26-27 April 2012, Brussels	OUT-04	€2.970
25-26 October 2012, Zurich	OUT-05	€2.970
Any discounts (e.G. FOR EARLY REGISTRATION) will be applied automatically

* (VAT excl.)

Payment details

VAT No:
Purchase Order No:
Promotional Code:

I wish to pay by bank transfer.

C.E.L.forpharma bvba c/o BNP Paribas Fortis Bank, Warandeberg 3 – 1000 Brussels
Account Nr. 001-4464979-48
IBAN: BE 11 0014 4649 7948 - BIC/SWIFT: GEBABEBB
On the bank transfer slip, please include the delegate name and the event code

I wish to pay by credit card (Amex, Master Card or Visa; a 3% surcharge will be applied)

Confirmation of Receipt of Payment is required before the start of the event

• An electronic version of the invoice will be sent to you within 2 days.
• If you have not received anything within 2 days, please call +32 (0)2 7092107 or send an e-mail to Tanya.petroffa@celforpharma.com
• Payment by credit card will be processed confidentially by Tanya Petroffa, Office Assistant, upon your agreement of the invoice. An electronic voucher will be subsequently sent to you for confirmation of the payment.

Cancellation & Transfer Policy:

• If a registrant cannot attend the scheduled course, he can avoid any cancellation charge by sending a suitable replacement participant.
• Alternatively the registrant can transfer once on a “space available” basis at no extra cost to another course held within one year of the original course date.
• If none of the above solutions suits, the following cancellation fees will apply:
       Cancelling 5 weeks or more prior to the course: cancellation fee of €250.
       Cancelling 4 to 3 weeks prior to the course: 25% of the full registration fee.
       Cancelling 14 to 7 workdays prior to the course: 50% of the full registration fee.
       Fewer than 7 workdays or if no notification received: registrant liable to pay full registration fee.
• If a registrant postpones his participation to a future course, and cancels again, no refund can be claimed for paid registration fees.
• If C.E.L.forpharma cancels an event, C.E.L.forpharma is not responsible for any airfare, hotel or other costs incurred by registrants.

Insurance and Liability

It is recommended that participants obtain adequate cover for travel, health and accident insurance before they depart from their countries. CE.L.forpharma as organiser cannot accept liability for personal injuries, or loss of, or damage to, private property belonging to the course participants and accompanying persons.

Privacy Policy

I confirm my registration and accept the conditions.