Forum 2012

APPLICATION FORM
for participation in the Third International Economic Forum
"INNOVATIONS. INVESTMENTS. KHARKIV INITIATIVES!"
2012

Applicant: /full name of enterprise/
Address	Legal address
	Postal address
E-mail		WWW
Kind of activity

**Head of the enterprise:**
Full name
Post
Phone/fax		E-mail

**Our enterprise wishes to participate in the Forum 2012 by the next way:**
#	Form of participation	Mark
1.	We wish to receive an invitation to the Forum for our members in number of
2.	We wish to make a report at the plenary session:
3.	We wish to participate in the forum as co-organizers
4.	We wish to participate in the forum as sponsors
5.	We wish to receive the CD-ROM with audio-visual records of reports on the forum

**Contact person:**
Full name
Post
Phone/fax		E-mail

Head of the enterprise	__________________________		"__"_______________2012
	(signature)

Send the application form by fax: +38 (057) 702-11-33

or by E-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it or send it by mail or courier to the address:

16, Lenina Avenue, Kharkiv 61166, Ukraine,1th Floor

Organizing committee of the Third International Economic Forum
"INNOVATIONS. INVESTMENTS. KHARKIV INITIATIVES!"

Additional information by phone: +38 (057) 702-11-33, 702-13-66; mobile: +38 (050) 501-36-66

or E-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it Forum web-site: www.led.org.ua

Forum 2012

Co-Organizers 2011

Sponsors 2011

Partners 2011