INNOVATIONQUALITY SUMMIT STUTTGART 2017

Online registration
The information you are about to provide will enable us to prepare an accurate description and presentation of your projects and needs in the official convention catalogue that is distributed to all participants.

Please tell us how you heard about INNOVATIONQUALITY SUMMIT STUTTGART 2017:

COMPANY’S PROFILE
COMPANY	*
Address	*
Address 2	*
Post Code	*
Town	*
Country	*
Phone (eg: +33(0)x xx xx xx xx)	*
Fax (eg: +33(0)x xx xx xx xx)	*
E-mail
Web Site
NAF Code
Registration N°
Creation date
Turnover	*
Number of employees	*
Group affiliation
Group's nationality
Member of an association, professional syndicate

REGISTRATION
Person in charge of this registration
Title	*
First Name	*
Name	*
Position
Mobile phone (eg: +33(0)x xx xx xx xx) Private to the organiser	*
Direct phone (eg: +33(0)x xx xx xx xx)	*
E-Mail	*

Identification of the participants
Participant 1
Title	*
First Name	*
Surname	*
Position	*
Mobile phone (eg: +33(0)x xx xx xx xx) Private to the organiser	*
Direct phone (eg: +33(0)x xx xx xx xx)	*
Direct Fax (eg: +33(0)x xx xx xx xx)	*
E-Mail	*
Department manager's (name, surname, position)
Participant 2
Title
First Name
Name
Position
Mobile phone (eg: +33(0)x xx xx xx xx) Private to the organiser
Direct phone (eg: +33(0)x xx xx xx xx)
Direct Fax (eg: +33(0)x xx xx xx xx)
E-Mail
Participant 3
Title
First Name
Name
Position
Mobile phone (eg: +33(0)x xx xx xx xx) Private to the organiser
Direct phone (eg: +33(0)x xx xx xx xx)
Direct Fax (eg: +33(0)x xx xx xx xx)
E-Mail
Participant 4
Title
First Name
Name
Position
Mobile phone (eg: +33(0)x xx xx xx xx) Private to the organiser
Direct phone (eg: +33(0)x xx xx xx xx)
Direct Fax (eg: +33(0)x xx xx xx xx)
E-Mail

OUR PROFILE

	Company
	University - Research Center
	Laboratories

Other (Precise)

MAIN ACTIVITY(IES) *

SECONDARY ACTIVITY(IES)

Production sites abroad

Select countries : None

REQUIRED PRODUCTS AND SERVICES

OUR FIELDS

	Aerospace / Aeronautic
	Railway
	Automotive
	Industrial Automation
	Medical / Biomedical / Healthcare
	Naval
	Others (specify)

MORE INFORMATION ABOUT US

Required technical references

Required certifications

FOCUS ON A MAIN PRODUCT/SERVICE OR AN INNOVATIVE PRODUCT/SERVICE

PARTNERSHIP

To supplement our range of products and skills, we are looking for partners in following domains:

		I agree to participate in the INNOVATIONQUALITY SUMMIT STUTTGART 2017 convention or to appoint a replacement in case I cannot attend myself.
		Replacement (Surname, First name, Position):