EMWA WEBSITE COMPANY LISTING

APPLICATION FOR ENTRY 2012

The company listing is a subscription service that allows EMWA members and non-members the opportunity to advertise their company's products and/or services.

Membership of the company listing is on an annual basis (from Jan through to Jan), and subscription fees are given below: The total annual listing fee for EMWA members is €500
Join in October - pay for 15 months i.e. €626
Join in November - pay for 14 months i.e. €584
Join in December - pay for 13 months i.e. €542
Join January to September - pay €500

The total annual listing fee for non-EMWA members is €1000

Join in October - pay for 15 months i.e. €1249
Join in November - pay for 14 months i.e. €1166
Join in December - pay for 13 months i.e. €1083
Join January to September - pay €1000

Please complete all 3 pages of this form.

Company

Address

Post code

Country

Email

Website

Details of company contact

Title

First nameLast name

Telephone+XX(0) xxx xxx xxx

Fax+XX(0) xxx xxx xxx

Mobile+XX(0) xxx xxx xxx

Email

Skills and services offered

Maximum 150 words

Expertise

Maximum 150 words

Other information

Maximum 150 words

Key words

Please list up to 10 key words or two-word phrases that Internet search engines can use to index your entry.

Key word 16 delete if not needed

Key word 27 delete if not needed

Key word 38 delete if not needed

Key word 49 delete if not needed

5 delete if not needed10 delete if not needed

Summary sentence (such as ‘Extensive writing/editing experience in all phases of drug development’)

Maximum 18 words/120 characters

How to submit your application

Please complete the following.

I am a current member of EMWA

I want a link to my website

I want to display my company logo

(Please supply any artwork for logos in a GIF file. If necessary, we can also lift a logo from a company website)

I understand that I will be invoiced according to the rates detailed on the front page of this form.

By submitting this entry I agree to the information on this form being held on a database solely for the purpose of display of my entry on the EMWA company directory.

Date

Please email your completed form to

Do not send payment with your application, we will send an invoice.

Note: the fee covers the posting of the entry and although we are happy to change contact details in the course of the year, other changes can be made only at the time of the yearly renewal.

EMWA website company directory: applicationPage 1 of 3