Belgium Testing Days 2012

	Early Bird ¹	Regular
“Influence and Authority: Using Your Personal Power to Get Things Done” Johanna Rothman	637,50 EUR ²	750,00 EUR ²
“Making Test Automation Work in Agile Projects” Lisa Crispin	552,50 EUR ²	650,00 EUR ²
“Test Estimation, Monitoring and Control” Lloyd Roden
“A mobile testing class” Karen N. Johnson
“Essential Software Requirements” Lee Copeland

	Alumni ¹	Early Bird ¹	Regular
Two-day conference March 13–14, 2012	712,50 EUR ²	807,50 EUR ²	950,00 EUR ²
One-day conference (day 1) March 13, 2012	412,50 EUR ²	467,50 EUR ²	550,00 EUR ²
One-day conference (day 2) March 14, 2012	412,50 EUR ²	467,50 EUR ²	550,00 EUR ²

Participant
Company:
Position:	(e.g. Test Manager)
Academic Title:	(Prof. or Dr.)
Salutation:	*
First Name:	*
Last Name:	*
Street:	*
ZIP Code:	*
City:	*
State:	(e.g. FL = Florida)
Country:	*
Phone:	*
Fax:
E-mail:	*

Billing Address (if different from above)
Company:
VAT ID:	(required if a company name is provided)
First Name:
Last Name:
Street:
ZIP Code:
City:
State:	(e.g. FL = Florida)
Country:
Phone:
Fax:
E-mail:	(required if a company name is provided)

Discount
	Please note: You can select only one of these special discounts.
Discount Code:
Alumni¹:	I am an alumni.
Membership:	Membership Number: (Verified members will be granted a 10 % discount.)
KMO-Portefeuille:	KMO-Portefeuille (Up to 50 % discount for SMEs located in the Flemish Region. For more information about the KMO-Portefeuille subsidy scheme and the conditions, check on www.kmo-portefeuille.be.)

Social Event:	Yes, I would like to attend the social event on March 13, 2012.
Remarks:	Please let us know if you require a special diet such as vegetarian, kosher, halal, etc. or if you have any other comments or questions.
	Notice of Cancellation No fee is charged for cancellation up to 60 days prior to the event. Up to 15 days prior to the event a payment of 50 % of the conference fee becomes due and after this a payment of 100 % of the course fee becomes due. An alternative participant can be designated at any time at no extra cost. Any cancellation has to be made in writing. Please note that for registrations using KMO-Portefeuille a special cancellation policy applies. Please find full details on vlaanderen.be. Settlement Date Payment becomes due no later than at the start of the event. Cancellations made after 15 days before the start of the conference will not be refunded. KMO-portefeuille AQIS bvba has an accredited training department: #DV.O109215

	Yes, I agree to the disclosure of my personal data (company name, name and e-mail address) to this year’s conference sponsors.
	By registration I accept the conditions above. *

* Required fields.
¹ Attendees who register before November 30, 2011 are eligible for the “Early Bird” registration. Attendees who register before November 30, 2011 and have attended last year’s BTD are eligible for the “Alumni” registration.
² All prices are excl. 21 % VAT.