Formulation Lab - Information

All information is required in English.
DO NOT fill in this form in BLOCK CAPITALS - Only use capitals for words that should be printed in capitals.
The personal information (contact name, telephone and email) will help us contact the right person in charge of your Formulation Lab session at in-cosmetics North America. Please note that this person will be contacted for any information related to your Formulation Lab session.

The following personal information will NOT be published

Contact name

Email

Phone
(including area code)

The following information WILL BE published

Name of the resenter

Presenter's job title

Presenter's company name

Presenter's biography
(100 words maximum)

Words left: 100/100

Presenter's email

Picture of the presenter
- High Resolution (at least 300 dpi) - JPEG or EPS format - Head & Shoulders

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Title of presentation
(no more than 80 characters - entries over this will be rejected)

Characters left: 80/80

Short abstract of the presentation
Describe what it is about and the benefits of attending the session (100 words maximum)

Words left: 100/100

Please select carefully the market segments and product categories related to your Technical Seminar (minimum 1 / maximum 5)

Market segment / Product Category 1

Choose the market segment 1

Choose the appropriate product category 1