Participation Form

European Minerals Forum Dinner Debate in the European Parliament Tuesday 14 April 2009 European Parliament Salon, Brussels

Participation Form I am pleased to accept / unable to accept your invitation (delete as applicable)

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European Parliament Pass PLEASE COMPLETE THE FOLLOWING SECTIONS TO CONFIRM RESERVATION

Do you have a EP pass ? YES

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If NO, we will obtain a temporary pass for you, but require the following details: Full Name……………………………………………………………………. ………………………………………………………………………………… PLEASE CONTINUE OVER THE PAGE

Date of birth……………………………………………………………………. Home Address…………………………………………………………………. …………………………………………………………………………………… …………………………………………………………………………………… Nationality……………………………………………………………………… Passport / ID card number…………………………………………………

I AM ARRANGING FOR A TRANSFER OF 95 € TO COVER DINNER COSTS TO BE MADE TO THE EUROPEAN BUSINESS FOUNDATION FORTIS BANK ,BRUSSELS : IBAN: BE17 0013 9325 1921 SWIFT: GEBABEBB SIGNED …………………………………………………………………… DATE………………………………………………………………… PLEASE INDICATE ON THE TRANSFER FORM YOUR NAME AND COMPANY/ORGANISATION

Other participant(s) from the same organisation are kindly requested to send separate registration forms

Please complete and return the Participation Form to: European Minerals Foundation Secretariat 39 Broughton Road London, W13 8QW E-mail: [email protected] Tel: +44 20 8579 4688 Fax: +44 20 8810 1712 The Foundation reserves the right to change the date or content of the programme should the circumstances require it.