REGISTRATION FORM
Connect to Investors
Mumbai, 23rd – 24th September 2013
Expression of Interest Form
Name of the Company/ Research
Organization/ University:
Contact person:
Designation:
Address:
Contact details
Tel.:
Mobile:
Fax:
Email:
Website:
Field of activity
Environment/ Energy/ Biotechnology/ Transport/ IT
application for the above sectors
Please give detail
Is the company already engaged
in international co-operation?
How did you get the information about the EBTC ‘s “Connect to Investors 2013” Program?
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EBTC (Website, Newsletter, event e-mailers, advertisements, phone call)
EBTC partners (Website, newsletter, event e-mailers, advertisements, phone call)
Local Chamber of Commerce / trade association/ other local institutions, please specify
EUROCHAMBRES
EBTC EU contact points, please specify
I understand that my details will be held by EBTC
Date: __________________
Authorized Signature: __________________________
For additional information or queries regarding this expression of interest form, please contact:
Italy - CEIPIEMONTE
Ms. Annalisa Gamba
Tel. +39 011 6700639
Ms. Antonella De Bonis
Tel. +39 011 6700671
E-mail: [email protected]
Europe - EUROCHAMBRES
Mr. Philippe Adriaenssens
E-mail: [email protected]
Tel. +32 (0)2 282 08 86
Ms. Sara Lanzillotta
E-mail: [email protected],
Tel. +32 (0)2 282 08 59
India - European Business and Technology Centre,
Mumbai
Mr. Shrikar Dole
E-mail: [email protected]
Tel. +91 22 42415750-98
Indo-Italian Chamber of Commerce and Industry
Mr. Sergio Sgambato
E-mail: [email protected]
Tel. +91 22 67728186