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SPONSORSHIP APPLICATION FORM Combined 33 rd SICOT & 17 th PAOA Orthopaedic World Conference

Exhibition & Sponsorship Application Form Combined 33 rd SICOT & 17 th PAOA Orthopaedic World Conference 28 November - 1 December 2012. SPONSORSHIP APPLICATION FORM Combined 33 rd SICOT & 17 th PAOA Orthopaedic World Conference. This agreement is to acknowledge the intention of:

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SPONSORSHIP APPLICATION FORM Combined 33 rd SICOT & 17 th PAOA Orthopaedic World Conference

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  1. Exhibition & Sponsorship Application Form Combined 33rd SICOT & 17th PAOA Orthopaedic World Conference 28 November - 1 December 2012

  2. SPONSORSHIP APPLICATION FORMCombined 33rd SICOT & 17th PAOA Orthopaedic World Conference This agreement is to acknowledge the intention of: Company:_________________________________________________________________________ Contact:__________________________________________________________________________ Title: _____________________________________________________________________________ Address 1: ________________________________________________________________________ Address 2:_________________________________________________________________________ City and Province/State : _____________________________________________________________ Postal Code: _________________ Country: _____________________________________________ Tel.: ________________________________ Fax: ________________________________________ E-mail: (mandatory) ___________________________________________________________________________ VAT No. (for EU companies) ___________________________________________________________ Sponsorship/Symposium or exhibition space requested:______________________________________ Signature:________________________________________________ If you have any questions please contact Mrs. Lina Salvati Linsa Inc. SICOT Commercial Agent Tel.: +1 450-458-7034 Tel.: +1 514 924 3476 Montreal, Quebec, Canada E-mail: lsalvati@linsa.ca

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