On line registration

Please follow the instruction in order to complete this registration form, properly

Thank you for filling the following questions

Contact details

Are you FEDIMA member ?

Forename

Name

Address

ZIP code

City

Country

Phone number

Cellphone number

Your e-mail address

Organisation you are representing

Dietary restrictions

Member

Are you a member of a Fedima committee ?

Are you the Secretary general of a National Association ?

Non Member

I'm attending the Fedima GA as a

Are you travelling with your partner ?

Please note the name of the accompagnying person- You can book dinner on the next page

First name

Last name

Do you require an invoice ?

Legal company name

VAT

Billing address

ZIP code

City

Country

PO Number

Billing e-mail address

Please create and fill your personal login and password

Password