Example Delegate Registration Form "*" indicates required fields Invoice NumberAttendee DetailsPlease provide details for the primary registrant. All fields are required.Name* First Last Job Title* Company* Location AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email* Phone*Mobile Phone*Please provide your direct contact number (including extension). This allows our success coordinators to reach you in regards to any deliverables required for your participation prior summit!Additional PassesAdd more passes for any additional attendees.*Single Pass Only2 Passes3 Passes4 Passes5 Passes6 PassesSecond AttendeeDetails for additional attendees, if available.Name First Last Job Title Email PhoneMobile PhoneThird AttendeeDetails for additional attendees, if available.Name First Last Job Title Email PhoneMobile PhoneFourth AttendeeDetails for additional attendees, if available.Name First Last Job Title Email PhoneMobile PhoneFifth AttendeeDetails for additional attendees, if available.Name First Last Job Title Email PhoneMobile PhoneSixth AttendeeDetails for additional attendees, if available.Name First Last Job Title Email PhoneMobile PhoneAdditional DetailsPlease provide further details about your organization or interest in further participation.Q1. How many people are employed by your organization as a whole?Select...Less than 500500 – 10001000 – 20002000 – 30003000 – 50005000 +UndisclosedQ2. Approximately what is the annual revenue generated by your organization as a whole?Select...Less than $80M$80M – $400M$400M – $800M$800M – $1.6BN$1.6BN +UndisclosedQ3. Are you interested in future opportunities to present on the agenda? Yes No Q4. Are you interested in contributing to the Generis Blog? Yes No Q5. Permission to acquire your bio from LinkedIn? Yes No Q6. What are your top three business challenges?***** Q7. What are the top three solution providers you would like to see at future meetings?****** Areas of SpecializationFor pre-scheduled one-to-one business meetings, which of the following areas are you interested in? 2-Shot Molding 3D Printing 3PL Advanced Planning & Scheduling Application Lifecycle Management Artificial Intelligence Assembly Services Asia Market Penetration Asia Regulatory Support Audit Management Solutions Automation and Equipment Blockchain Business Performance Management Business Process Automation Change Management Solutions Clinical Trial Clinical Trial Support Cloud Solutions Coatings Components Connected Device Technology Content Management Solutions Contract Manufacturing Cost Reduction Customer Satisfaction Customer Training Solutions Cybersecurity Data Analytics Data Capture Design for Manufacturability Device Classification Disruptive Innovation Document Control eDHR Solutions EHSQ Electronics Design & Development Electronics Manufacturing Services EMC Testing End-to-End IT Solutions Enterprise Portfolio Management Environmental Testing eQMS ERP Solutions Error Prevention EU MDR Extractables & Leachables Testing Extrusions Facility Design & Expansion Health & Safety Human Factors Industry 4.0 Infrared Sensors Injection Molding International Market Penetration International Regulations International Regulatory Support Intellectual Property Legal Service IoT Labeling Lean Manufacturing Learning and Development Legal Services Liability Management Liquid Injection Molding Localization Low Cost Country Sourcing Material Handling Material Testing Medical Adhesives Medical Device Pricing Medical Device Reporting Medical Device Tax Medical Device Writing Medical Filtration Medical Package Testing Medical Writing MES Metal Injection Molding Metrology Micro-Machining Micro-Molding Mobile Solutions Multi-shot Injection Molding Non Destructive Testing Obtaining 510k Clearance Operational Excellence On-Demand Manufacturing Organizational Structure Optical Sensors Outsourced Product Development Solutions Packaging Solutions Physical Testing Plastic Injection Molding Plastics Heat Sealing Post-Market Surveillance Precision Components Premarket Approval Process Control Solutions & Equipment Process Engineering & Design Process Validation Product Design Product Development Product Lifecycle Management Project Management QMS Quality & Cost Management Quality Management Rapid Manufacturing Rapid Prototyping Recall Strategy Recruitment Regulatory Challenges Regulatory Intelligence Regulatory Information Management Regulatory Outsourcing Regulatory Writing Services Reimbursement Relocation Opportunities Requirements Management RFID Risk Management Robotic Process Automation Safety Testing Silicone Molding Silicone-plastic bonded Molding Six Sigma Consulting/Training Software Development Services Software Testing Sourcing & Procurement Solutions Sterility Validation Sterilization / Decontamination Supplier Management Supplier Oversight Supply Chain & Logistics Supply Chain Traceability Supply Chain Visibility Surface Treatments Tech Transfer Temperature Control Track & Trace Translation Solutions Tooling UDI Software UDI Solutions Upskilling User Interfaces Validation Work Flow Automation Workforce Training X-Ray Sensors Approximately how much is your company planning to invest in the above areas?Select...Less than $1.5M$1.5M – $7M$7M – $15M$15M – $75M$75M – $150M$150M +UndisclosedTerms & ConditionsPlease review the Terms & Conditions and Privacy Policy. Your Date of Birth will act as your digital signature.Service Agreement* I acknowledge that I have read and agree to the Terms & Conditions and Privacy Policy.Terms & Conditions Privacy PolicyPermissions Generis may obtain company's logo from company's corporate website for branding purposes. (Please uncheck this box if you do not agree.)Booking Code Please confirm your Date of Birth:*MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Package OptionVIP Delegate PackageVIP Delegate Package + On-Demand ContentOn-Demand ContentVIP Delegate Package — European Medical Device Summit Price: On-Demand Content Price: Discount CodeIf you have a promotional discount code, enter it here. Discount Price: Subtotal 0.00 € Service Fee (18%) 0.00 € VAT (19%) 0.00 € Total Including 18% service fee.PaymentPayment is processed securely through our payment processor. We do not retain any payment information.Payment Method* Credit Card PayPal Credit CardCard Details Cardholder Name Click Register to continue to PayPal
