Registration Form for the Seminar:
Operation and Maintenance of Centrifuges

To:
ANDRITZ KMPT GmbH
Mrs. Nicole Entrup
Industriestrasse 1-3
85256 Vierkirchen
Phone: 	+49(0) 8139-80299-500
Fax: 	+49(0) 8139-80299-550
Seminar.Service.KMPT@andritz.com

Yes, I hereby submit my binding registration for the Seminar on “Operation and Maintenance of Centrifuges”
(810,- € per person plus 19% VAT) .

The application is herewith binding. ANDRITZ KMPT reserves its rights to charge the buyer with a cancellation fee of 200,- € in case the written cancellation reaches ANDRITZ KMPT one Month prior to the seminar latest. Afterwards the whole seminar price will be invoiced.

Please note, that we are entitled to cancel the event if the number of participants is too small.
Dates (please mark with a cross)                                                                                                                                   The closing date for registration is 1 month before the start of seminar.
	25th – 26th Oct 2016	(German)	
		
	20th – 21th Oct 2016	(English)	
Address of Seminar participant: 
Surname:		
First name:		
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Postal code / City:		
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Phone:		
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e-mail:			Your invoice address: 
Company name:	…………………………………….……
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Further Information:
Type of centrifuge in operation:		
Application / Product:    …………………………………	Seminar contents:
Your expectations:		

Date:							Company stamp + signature: