Booth Application Form

Title (*)

Last Name (*)

First Name (*)

Job title (*)

Other Job title

Company (*)

Address (*)

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Industry Sector (*)

RUC

Phone (*)

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Web

Products to exhibit

Services to exhibit

Payment Method

Wire Transfer to account U.S.$ de Thais Corporation S.A.C.

Bank:	INTERBANK (Banco Internacional del Perú)
Address:	Carlos Villaran 150 - Urb. Santa Catalina - Lima 13, Peru Tel: (511) 219-2000
Account Nº:	059-001032046-9
Owner:	Thais Corporation S.A.C.
Swift:	BINPPEPL
C.C.I. N°	00305900001032046939

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 (*)