Petrochemical & Refining Summit 2019

26-28 August 2019, The Roosevelt, New Orleans – Waldorf Astoria Hotel, LA
This form is solely for attendees whose participation has been confirmed at the summit.
*Where indicated, field must be completed so that the form will be successfully sent to the Event Manager.
Personal Details
Please note that the information you give below will be used to create your name badge.
* Full Name
* Job Title
* Company
* Mobile
* Email
Transport Details

Summit begins Monday, August 26, 2019      Summit ends Wednesday, August 28, 2019

CLICK THE RELEVANT SECTION BELOW TO CONFIRM METHOD OF TRANSPORT
Air
* Arrival Details
Arrival Flight No. Arrival Airport
Arrival Date Arrival Time
* Departure Details
Departure Flight No. Departure Airport
Departure Date Departure Time
Bus
Bus Details
* Arrival Date * Departure Date
* Arrival Time * Departure Time
Arrival Station Departure Station
Car
* Car Details
Arrival Date Departure Date
Arrival Time Departure Time
ACCOMMODATION:
marcus evans has reserved accommodation for the summit
I need accommodation I do not need accommodation
Please complete to ensure a room is booked for you accordingly.
* Arrival Date * Departure Date
* Arrival Time * Departure Time
Please note all rooms are non-smoking
A number of rooms are available within the Hotel for guests with disabilities. Please advise if you have any special needs:
Additional Nights Accommodation:
If you require additional accommodation outside the summit, please complete the below section.
All bookings for extra nights accommodation are subject to availability and at your own expense. You must ensure that any additional personal expenses, including additional accommodation, are settled in full before departing the hotel.
I need additional accommodation
* Dates required:
* Single/Double occupancy:
* Name on credit card:
* Credit card type:
* Credit card number:
* Expiry date:
Visa Requirements
I require a visa
If you require a visa to enter please complete:
* Full Name on Passport * Date of Birth
* Passport Number * Place of Birth
* Passport Date of Expiry * Passport Place of Issue
* Nationality
Full address and telephone number to courier original visa letters to:
Catering Requirements
Please advise if you have any special requirements (e.g. vegetarian, lactose free etc.)
Additional Comments
Please advise if you have any additional comments