Delegate Registration
Register as a delegate (Invoice)
Step
1
of
7
14%
Number of delegates
(Required)
If you are registering on behalf of multiple colleagues, you will need their details to hand in order to complete registration.
Select
1 Delegate (£220.00) ex VAT
2 Delegates (£440.00) ex VAT
3 Delegates (£660.00) ex VAT
4 Delegates (£880.00) ex VAT
5 Delegates (£1100.00) ex VAT
Your details
First Name
(Required)
Last Name
(Required)
Email
(Required)
Enter Email
Confirm Email
Job Title
(Required)
Company Name
(Required)
Industry
(Required)
Academic R&D
Air Traffic Management
Automotive
Civil Avionics
Energy
Environmental
Financial
Industrial Automation
Medical
Military
Rail
Space
Other
Phone Number
There may be a need to contact you should there be any changes to the event. If you would like to be contacted by phone, please provide your phone number.
Dietary / Allergy Requirements
Please let us know your dietary or allergy requirements
Access Requirements
Please let us know any access or other requirements
Are you happy to be photographed/videoed at the conference?
(Required)
Yes
No
Are you happy for your name, job title and company name to be included on the delegate list?*
(Required)
Yes
No
I agree to the conference terms and conditions
(Required)
A link to terms and conditions can be found at the bottom of this page.
Yes
Your data and privacy
(Required)
ZiaBia has been appointed by AdaCore and Capgemini Engineering to process your information submitted in this form for the sole use of delivering this year’s HIS conference and providing information about future HIS conferences. By ticking this box you are confirming acceptance of the use of your data as outlined in their privacy statement. A link to the privacy policy can be found at the bottom of this page.
I understand
Stay up-to-date with Capgemini
I’m also interested in periodically receiving content related to Capgemini Engineering, and discussing with an expert about how Capgemini Engineering can support customers with our world-leading engineering and R&D services and digital manufacturing expertise.
Yes
No
Stay up-to-date with AdaCore
I’m also interested in periodically receiving AdaCore-related content, and discussing with an expert about how AdaCore helps companies build, modernise, and maintain critical software systems.
Yes
No
Your colleague's details
First Name
(Required)
Last Name
(Required)
Email
(Required)
Enter Email
Confirm Email
Job Title
(Required)
Dietary / Allergy Requirements
Please let us know your dietary or allergy requirements
Access Requirements
Please let us know any access or other requirements
Are you happy for your name, job title and company name to be included on the delegate list?*
(Required)
Yes
No
Are you happy to be photographed/videoed at the conference?
(Required)
Yes
No
Your data and privacy
(Required)
ZiaBia has been appointed by AdaCore and Capgemini Engineering to process your information submitted in this form for the sole use of delivering this year’s HIS conference and providing information about future HIS conferences. By ticking this box you are confirming acceptance of the use of your data as outlined in their privacy statement. A link to the privacy policy can be found at the bottom of this page.
I understand
I agree to the conference terms and conditions
(Required)
A link to terms and conditions can be found at the bottom of this page.
Yes
Stay up-to-date with Capgemini
I’m also interested in periodically receiving content related to Capgemini Engineering, and discussing with an expert about how Capgemini Engineering can support customers with our world-leading engineering and R&D services and digital manufacturing expertise.
Yes
No
Stay up-to-date with AdaCore
I’m also interested in periodically receiving AdaCore-related content, and discussing with an expert about how AdaCore helps companies build, modernise, and maintain critical software systems.
Yes
No
Colleague 2 details
First Name
(Required)
Last Name
(Required)
Email
(Required)
Enter Email
Confirm Email
Job Title
(Required)
Dietary / Allergy Requirements
Please let us know your dietary or allergy requirements
Access Requirements
Please let us know any access or other requirements
Are you happy to be photographed/videoed at the conference?
(Required)
Yes
No
Are you happy for your name, job title and company name to be included on the delegate list?*
(Required)
Yes
No
Your data and privacy
(Required)
ZiaBia has been appointed by AdaCore and Capgemini Engineering to process your information submitted in this form for the sole use of delivering this year’s HIS conference and providing information about future HIS conferences. By ticking this box you are confirming acceptance of the use of your data as outlined in their privacy statement. A link to the privacy policy can be found at the bottom of this page.
I understand
I agree to the conference terms and conditions
(Required)
A link to terms and conditions can be found at the bottom of this page.
Yes
Stay up-to-date with Capgemini
I’m also interested in periodically receiving content related to Capgemini Engineering, and discussing with an expert about how Capgemini Engineering can support customers with our world-leading engineering and R&D services and digital manufacturing expertise.
Yes
No
Stay up-to-date with AdaCore
I’m also interested in periodically receiving AdaCore-related content, and discussing with an expert about how AdaCore helps companies build, modernise, and maintain critical software systems.
Yes
No
Colleague 3 details
First Name
(Required)
Last Name
(Required)
Email
(Required)
Enter Email
Confirm Email
Job Title
(Required)
Dietary / Allergy Requirements
Please let us know your dietary or allergy requirements
Access Requirements
Please let us know any access or other requirements
Are you happy to be photographed/videoed at the conference?
(Required)
Yes
No
Are you happy for your name, job title and company name to be included on the delegate list?*
(Required)
Yes
No
I agree to the conference terms and conditions
(Required)
A link to terms and conditions can be found at the bottom of this page.
Yes
Your data and privacy
(Required)
ZiaBia has been appointed by AdaCore and Capgemini Engineering to process your information submitted in this form for the sole use of delivering this year’s HIS conference and providing information about future HIS conferences. By ticking this box you are confirming acceptance of the use of your data as outlined in their privacy statement. A link to the privacy policy can be found at the bottom of this page.
I understand
Stay up-to-date with AdaCore
I’m also interested in periodically receiving AdaCore-related content, and discussing with an expert about how AdaCore helps companies build, modernise, and maintain critical software systems.
Yes
No
Stay up-to-date with Capgemini
I’m also interested in periodically receiving content related to Capgemini Engineering, and discussing with an expert about how Capgemini Engineering can support customers with our world-leading engineering and R&D services and digital manufacturing expertise.
Yes
No
Colleague 4 details
First Name
(Required)
Last Name
(Required)
Email
(Required)
Enter Email
Confirm Email
Job Title
(Required)
Dietary / Allergy Requirements
Please let us know your dietary or allergy requirements
Access Requirements
Please let us know any access or other requirements
Are you happy to be photographed/videoed at the conference?
(Required)
Yes
No
Are you happy for your name, job title and company name to be included on the delegate list?*
(Required)
Yes
No
I agree to the conference terms and conditions
(Required)
A link to terms and conditions can be found at the bottom of this page.
Yes
Your data and privacy
(Required)
ZiaBia has been appointed by AdaCore and Capgemini Engineering to process your information submitted in this form for the sole use of delivering this year’s HIS conference and providing information about future HIS conferences. By ticking this box you are confirming acceptance of the use of your data as outlined in their privacy statement. A link to the privacy policy can be found at the bottom of this page.
I understand
Stay up-to-date with Capgemini
I’m also interested in periodically receiving content related to Capgemini Engineering, and discussing with an expert about how Capgemini Engineering can support customers with our world-leading engineering and R&D services and digital manufacturing expertise.
Yes
No
Stay up-to-date with AdaCore
I’m also interested in periodically receiving AdaCore-related content, and discussing with an expert about how AdaCore helps companies build, modernise, and maintain critical software systems.
Yes
No
Payment Information
Billing Address
(Required)
Please let us know your billing address, which will also be printed on your invoice.
Address line 1*
Address line 2
Town / City*
County*
Post Code*
Do you need a Purchase Order?
(Required)
I need a quote to generate the PO number before an invoice can be raised
No
Yes
For the attention of (Name)
(Required)
Finance Email
(Required)
Finance Phone Number
(Required)
Department
(Required)
Company Name
(Required)
Company Address
(Required)
Please let us know your billing address, which will also be printed on your quote.
Address line 1*
Address line 2
Town / City*
County*
Post Code*
View Privacy Policy
|
View Terms & Conditions