Brand name*: Company name*: Street*: Postcode*: Adress*: Country:  Sélectionnez Afghanistan Afrique du Sud Albanie Algérie Allemagne Andorre Angola Antigua-et-Barbuda Arabie saoudite Argentine Arménie Australie Autriche Azerbaïdjan Bahamas Bahreïn (masc.) Bangladesh Barbade Belau Belgique Belize Bénin Bhoutan Biélorussie Birmanie Bolivie Bosnie-Herzégovine Botswana Brésil Brunei Bulgarie Burkina Burundi Cambodge Cameroun Canada Cap-Vert Chili Chine Chypre Colombie Comores Congo Congo Rep Cook Corée du Nord Corée du Sud Costa Rica Côte d'Ivoire Croatie Cuba Danemark Djibouti Dominique Égypte Émirats arabes unis Équateur Érythrée Espagne Estonie États-Unis Éthiopie Fidji Finlande France Gabon Gambie Géorgie Ghana Grèce Grenade Guatemala Guinée Guinée-Bissao Guinée équatoriale Guyana Haïti Honduras Hongrie Inde Indonésie Iran Iraq Irlande Islande Israël Italie Jamaïque Japon Jordanie Kazakhstan Kenya Kirghizistan Kiribati Koweït Laos Lesotho Lettonie Liban Liberia Libye Liechtenstein Lituanie Luxembourg Madagascar Malaisie Malawi Maldives Mali Malte Maroc Marshall Maurice Mauritanie Mexique Micronésie Moldavie Monaco Mongolie Mozambique Namibie Nauru Népal Nicaragua Niger Nigeria Norvège Nouvelle-Zélande Oman Ouganda Ouzbékistan Pakistan Panama Nouvelle Guinée Paraguay Pays-Bas Pérou Philippines Pologne Portugal Qatar République centrafricaine République dominicaine République tchèque Roumanie Royaume-Uni Russie Rwanda Sainte-Lucie Saint-Marin Saint-Siège Salomon Salvador Sénégal Seychelles Sierra Leone Singapour Slovaquie Slovénie Somalie Soudan Sri Lanka Suède Suisse Suriname Swaziland Syrie Tadjikistan Tanzanie Tchad Thaïlande Togo Tonga Trinité-et-Tobago Tunisie Turkménistan Turquie Tuvalu Ukraine Uruguay Vanuatu Venezuela Viêt Nam Yémen Yougoslavie Zaïre Zambie Zimbabwe Phone number*: Fax*:     E-mail*: Website:     Field of activity*: Products and services*:     Exhibit contact person Title*: Fonction*: Phone*: Fax*: Email*: • The minimum booth area is 9m2. • Your exhibit area includes: room-dividers, fitted carpet, 1 table, 3 chairs, company name, lighting and Internet. • Taxes are not included in the mentioned prices. • Resident exhibitors will pay in Dinars; non resident ones will pay in Euros • Registration and booth confirmation deadline is October 31th, 2010. • A fully detailed written confirmation of your booth reservation will be sent to you as soon as payment is received. Please tick your choice AREA EQUIPPED BOOTH PRICE 9 m2 1800 18 m2 3500 27 m2 5200 Booths are allocated on a first come-first served basis.   * ADVERTISING PRICE Pair internal page 500 Impair internal page 700 Third cover page 1000   Amount Ads in the catalogue are allocated unless available, first come-first served. Total Amount     Only transfer payment to Tunis Chamber of Commerce and Industry account is accepted   BANK: BANQUE NATIONALE AGRICOLE IBAN: TN 59 03 0000 100 101 220 515 68 RIB: 03 0000 100 101 220 515 68 SWIFT: BNTETNTT   Please fax a copy of the SWIFT to +(216) 71 247 291 / +(216)71 333 945                 +(216)71 333 945   Registration deadline is November 15th, 2010. The registration becomes valid after payment is received. *I have read and accepted without any restriction the terms of Tunis-MedFranchise rule 2010 from which I have a copy. *I, undersigned, certify that all information given in this form is true, correct and complete. *Fields Required TheTunis Chamber of Commerce and Industry Phone : +(216) 71 247 322 Fax : +(216) 71 247 288 / +(216) 71 247 291 salon@tunis-medfranchise.com