Registration Form
Company name
*
Last name
*
3 + 0 =
*
Email
First name
Job title
E-mailaddress
*
Name@company.com
Fee
This networking dinner is exclusively for members of Agoria, Agoria Automotive Technology Club, and RAI Automotive Industry NL.
For members of Agoria Automotive Technology Club and RAI Automotive Industry NL, participation of the first attendee per organization is free of charge. From the second person the participation fee is € 125.00 (excl. VAT) per person.
For members of Agoria, the participation fee is € 125.00 per participant (excl. VAT).
Please, note that there is a no-show-fee of € 125.00 (excl. VAT) per person.
In case of absence, a substitute participant is allowed at no additional cost.
I have noticed that the no-show fee is €125,- excl. VAT
*
Yes
Do you have any dietary requirements?
*
No
Yes, please note your wishes:
We will include the company name of the participants on our website. Do you give permission to mention your company name?
*
Yes
No
During this event, we will take photos and videos. You give permission for us to publish these.
*
Yes, I give permission
Social media
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