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Your registration !

 

Only for International visitors !

 

To visit SPACE 2012, which will take place from 11 to 14 September, please pre-register by filling the following application.

In return, you will receive an email confirming your pre-registration. 

 

Then, just print this email and present it at the entrances. The hostesses will give you your badge valid for four days.


* Civility:

   Miss     Mrs     Mr
     

* Surname:

  
     

* First name:

  
     

Company name:

  
     

Address:

    

Zone:

  
     

* Street:

  
     

PO Box:

  
     

Postal Code:

  
     

* City:

  
     

* Country:

  
     

* Phone number:

  
     

Fax number:

  
     

* Email:

  
     

* Thank you for confirming your email:

  
     
* Your function:  
     
* Your sector:  
     
* Your activity:  
 

 


The fields with * must be filled

These information will be treated and stored by computers ways. They are for the organizer SPACE, and they can be given to other organisms. According the computer and freedom law dated 06/01/1978, you have a right of access, modification and opposition on your information in contacting SPACE by post : SPACE - Rue Maurice Le Lannou - CS 54239 - 35042 Rennes Cedex (France).