Schothorst Feed Research B.V.
Registration form Feeds & Nutrition 2015, RegardzZilveren Toren in Amsterdam
1. Participant (please fill out all fields)
Name : Ms Mrs Mr Dr
First name :
Initial(s)of first name(s) only: (for certificate of participation)
Position:
Phone number: Mobile:
Country of origin :
E-mail:
2. Company details for invoice (please fill out all fields)
Send to e-mail address : Invoice will also be sent to participant
Company name:
Attention of:
Address:
Areal code/ city:
Country:
Telephone number:
VAT-number (for tax free invoice)*: (outside of the Netherlands only)
Order no (if applicable) :
*Only if the VAT number is registered, the invoice will be sent without VAT
Invoice in hard copy needed : yes If not indicated otherwise, invoice will only be sent per e-mail/PDF
3. Module choicePlease choose your Module program
I would like to register for the Modules: (please indicate)
Module 1 (Feedstuffs) Day 1 and 2, June 12 (2 day course)
Module 2 (EU Feed legislation) Day 3, June 3 (1 day) or
Module 3 (Feed processing) Day 3, June 3(1 day) or
Module 4 (Least cost formulating) Day 3, June 3(1 day) or
Module 8 (Mycotoxins and ANF’s) Day 3, June 3 (1 day) or
Module 10 (Recent developments) NEW Day 3. June 3 (1 day)
(Only one Module (2, 3, 4, 8 or 10) possible on Day3)
Module 5 (Dairy nutrition) Day 4 and 5, June 45 (2 days) or
Module 6 (Swine nutrition) Day 4 and 5, June 4 & 5 (2 days) or
Module 7 (Poultry nutrition) Day 4 and 5, June 4 & 5 (2 days) or
Module 9 (Risk management) Day 4 and 5, June 4 & 5 (2 days)
(Only one Module (5,6,7, 8 or 9) possible on Day 4 and 5)
4. ExcursionsMore info will be sent by e-mail.
Free programs
I would like to participate on the free excursion on
Monday evening, June 1
Cruise on the canals of Amsterdam, including dinner.
Yes, I would like to participate
No, I would not like to participate, thank you
Thursday evening, June 4
I would like to have dinner with my Dairy/Swine/Poultry/Quality control class on Thursday evening,7 PM.
I will not have dinner with my class on Thursday, thank you
------
Feed mill excursion, attendance fee € 100,-
I would like to participate on the free excursion on Saturday, June 6 (including BBQ at SFR).
Program from 9.00 AM (Amsterdam) to 6.00 PM.
Yes, I would like to participate
Please indicate one animal category for your visit Poultry Ruminants Swine
No, I would not like to participate, thank you
6. Dietary requirements
Do you have any dietary requirements, please indicate what you would like us to take into account?
7. Lodging
Please indicate if and what night(s) you would like Schothorst Feed Research to make a reservation at
1. No thank you, I will make reservations myself if needed
2. Ibis hotel*, next to Regardz (meeting center) double room (± € 143.00, incl. breakfast/excl VAT)
(small rooms, 3) double use of room (± € 158.00 ,, )
3. Hotel Amsterdam De Roode Leeuw standard room ( € 169.00 excl. of breakfast/incl VAT)
(700 m from Regardz, 4) double use of room also € 169,- .. .
(only a few rooms available)
For the night(s) of
May31 June 1 June 2 June 3 June 4 June 5 June 6
(Sun) (Mon) (Tue) (Wed) (Thu) (Fri) (Sat)
* Ibis payment : cash /PIN/ creditcard at the hotel only
Roode Leeuw : cash /PIN/ credit card at the hotel, proforma invoice possible
* Costs of lodging are excluded from the costs of the course and payment is the responsibility of the participant. Information on location will be sent by e-mail.
8. Parking
Would you like to park your car at P1 (parking lot) at walking distance from Regardz?
Costs are either € 20,- or € 25,- a day, with a maximum of 5 days. More info will be sent by e-mail.
Please go to (license plate number of car is needed)
Please be aware that parking is per 24 hours (f.i. a reservation for 2 days, driving in June 3 at 8.30 AM and drving out max 8.30 AM on June 5. After this time costs are € 2.50 an hour.
(If you have any questions or difficulty reserving P1, please contact Susan Gijsen.)
9. Letter of invitation
Please check if a letter of invitation is required. If so, please fill out all fields and we will the letter per e-mail as soon as possible.
Full official name
Date of birth
Passport number Issue date and expiration date
This letter should be addressed to the following embassy/consulate
Embassy/consulate name
Address
Areal code
Country
10. Information on courses and seminars organized by SFR
Yes, I would like to receive invitations and information on all courses and seminars of SFR
No, I would not like to receive invitations and information by e-mail besides on Feeds & Nutrition
in
English and/or
Dutch
How did you learn about the Feeds & Nutrition course?
from one of Schothorst Feed Research’s (SFR) employees
by e-mail from SFR
SFR website
another internet site:
Kraftfutter Feed Magazine
associate/client
11. Agreement
Participant has read and agrees with the information provided in this form and understands that registration is not final until payment has been received by SFR and that cancellation with refund is only possible no less than 2 weeks before the start of the course (before May 18).
Date:
8. Conditions
Payment is to be received by SFR max 2 weeks before start of the training and inclusive of VAT (with the exception of foreign companies if the VAT number is known to SFR). Prices are not negotiable.
-Canceling your participation only in writing by letter, fax or e-mail to: .
-The costs of cancelation 7 to 14 days before the (first day of ) the course are 50% of the participation fee.
-In case of cancelation less than 7 days before the (first day of) the course the participation fee will not be refunded.
REGISTRATION
Please send in this completely filled out form before May 4, 2015by mail, faxor e-mail to:
Schothorst Feed Research B.V., Attn S.L. Gijsen
PO Box533, 8200 AM Lelystad, Fax: 0320-255030 E-mail:
Thank you for joining our Feed & Nutrition course!
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