Booth Application Form

Title (*)

Last Name (*)

First Name (*)

Job title (*)

Other Job title

Company (*)

Address (*)

Country (*)

State (*)

City (*)

Zip Code (*)

Industry Sector (*)

RUC

Phone (*)

Email (*)

Web

Products to exhibit

Other Products

Services to exhibit

Other Services

Payment Method

Wire Transfer to US$ account of Plastic Concept S.A.C.:

Account Nº:	000-2867461
Owner:	PLASTIC CONCEPT S.A.C.
Bank:	SCOTIABANK S.A.A.
Address:	Av. Dionisio Derteano 102 – San Isidro. Lima 27, Peru. Tel: (511) 211-6000
Swift:	BSUDPEPL

Online payment:

Textile Reactivation - US$ 350.00 per Stand

Textile Reactivation - Innovation - US$ 650.00 per Stand

Textile Reactivation - Sustainability - US$ 950.00 per Stand

*Send payment receipt and Passport number to admon2@plastic-concept.com
** Remember to return to this website to finalize your reservation

Credit Card

Type of Card (*)

Card Nº. (*) - - - -
The last three numbers of the card are listed at the back of the card next to the signature.

Expiry Date (*)

Owner Card (*)