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February 2009

Registration Form

Bsik Smart Surroundings Event
Wednesday 4 March 2009
The Hague
(one form per person please)

  • Name:
  • Initials: Mr./Ms.*
  • Organisation:
  • E-mail:
  • Telephone:
  • [ ] I’d like to visit the knowledge fair *
    • [ ] I’d like to join for lunch *
    • [ ] I’d like to reserve a car park space *
  • [ ] Unfortunately I will not participate *

(Please select what is applicable)

Please return this registration form before 26 February 2009
to SenterNovem Bsik, attn. Kamla v.d. Lelie,
P.O. Box 93144 - 2509 AC The Hague – The Netherlands
by fax: +31 70 373 5100
by e-mail: bsik@senternovem.nl

Please direct any questions regarding logistics to Anneke van Staden
Tel.: +31 70 373 56 62