LEAD-ACID BATTERIES DEPARTMENT111

ONLINE REGISTRATION FORM - CARD PAYMENT

Note: This online registration form can be used for registration of one delegate only. Fields marked with* are mandatory

* Name

*Surname

* Title

*Job position

* Email

Alternative Email (optional)

Telephone

Fax

* Company/Organization

* Mailing Address

* City

State/Province

Zip code

* Country

Any special comments or requirements:

I consent to my names, affiliation and job position to be published in the LABAT’2021 list of participants*

Yes, I agree

No, I do not agree

I have read and I agree to the LABAT’2021 Terms and Conditions and Privacy Policy.*