Please complete the following form with the information on your company and its attending delegates. When you are finished, press the SUBMIT button appearing at the bottom of the page. * Required information BUYERS AND SPECIFIERS Company* Address* Country* Select:* Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo-Brazzaville Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroes Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong SAR of China Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao SAR of China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Marianas Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino São Tomé e Príncipe Saudi Arabia Senegal Serbia Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea Spain Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand The Bahamas Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay US Virgin Islands Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Phone (country code)* VAT (for EEC countries) Postcode* City* Website* Company presentation (Max. 1000 characters)* Number and location of future projects* Person who performs the registration on behalf of the company Title Select: Mr. Mrs. Ms. Select: Dr. Prof. First name* Surname* Job title* Mobile phone (inc. country code)* Email* Additional comments Delegate 1 Title Select: Mr Madame Ms. Select: Dr. Prof. First name* Surname* Job title* Phone (inc. country code)* Mobile phone (inc. country code) Email* CC Email Delegate photo Delegate 2 Title Select: Mr Madame Ms. Select: Dr. Prof. First name Surname Job title Phone (inc. country code) Mobile phone (inc. country code) Email CC Email Delegate photo Login details Choose login email* Choose login password* Important notes Company and delegate information entered here will be displayed in the Delegates area of the event website and in the printed event directory. The responsibility for accuracy of information rests solely with delegates and the companies they represent. 1 Mobile phone numbers are only used for organisational purposes and not displayed in any online or print documents. 2 If you wish a copy of your e-mails to be sent to an additional person (e.g. your assistant), please enter the email address into this field. Terms & Conditions The flights, transfers from the airport to the hotel and back (only on March 13 and 16), three nights of accommodations at the hotel, and breakfast, lunch and dinner in accordance with the schedule, shall be provided and organised by Madison Business Forums S.L. During the work sessions, the buyers will be given their own space inside of the hotel, equipped with a desk, chairs and complementary services. This is where all of the meetings will be taking place. Only those individuals who are officially registered and confirmed by Madison Business Forums S.L. may attend the event. The delegates are responsible for having their own travel insurance, visas, vaccines, etc. The aforementioned are not the responsibility of Madison Business Forums S.L. Those participating in HOSPITALSPEC must agree that the use of all photographic images and video footage taken during the event may be used by the organiser, Madison Events S.L. for the promotion of future events, if it so wishes. By submitting this registration form, you are confirming that you have the authority necessary to act in representation of the company being registered. Confirmation of places reserved for the event will be sent out in accordance with the criteria of Madison Business Forums S.L. Madison Business Forums S.L. reserves the right to amend the Terms and Conditions at any time with no prior notice or warning. * Mark this box to confirm that you wish to register and accept the contracting terms and conditions indicated above. * I accept the fact that my personal information will be used by Madison Business Forums S.L. for the sole purpose of providing the requested services. I agree that Madison Business Forums S.L. may divulge my personal information if required by Law or a court order.