Please complete and submit the following form to register for the E3 Standby Power and Battery Charger Forum, not later than 9 September 2011. As space is limited, preference will be given to early registrations.

Fields marked with a ^ must be completed.
Personal Information
Mr Mrs Miss Ms Dr
First Name^
Last Name^
Position
Department
Company/Organisation^
Address Details
Address^
Location/City^
Postcode
Country^
Phone Number^	Country Code:    Area Code:       Number:
	+
Mobile Number^	Country Code:    Number:
	+
Email Address^
Confirm Email Address^
Special Dietary Needs (leave blank if not applicable)
Vegetarian
Vegan
Islamic
Other (Please note below)
Other comments or notes for the registration: