Family name

First name

Date of birth (Day/Month/Year)

Passport/ID number

E-mail

Phone

Function

Organisation Organisation type

Partner? Yes: No:

Address of the organisation: Street Number Zip code

City Country

Cocktail registration: 18 October 2011, 19h00 Berlaymont Piazza

I will attend the cocktail? Yes: No:

Enter the code exactly as it appears.
There is no zero and the text it's not case sensitive.

Confirmation Code

DG ECHO Conference 2011