1     Name of Company or Institution

Company*:

Address*:  

Country:    Antigua and Barbuda Aruba The Bahamas Barbados Belize Colombia Costa Rica Cuba Dominica Dominican Republic El Salvador Grenada Guatemala Guyana Haiti Honduras Jamaica Mexico Nicaragua Panama St Kitts Nevis St. Lucia St Vincent & the Grenadines Suriname Trinidad & Tobago Venezuela France Netherland Antilles Other      If other please identify:    

Telephone* :    

Fax*:         

E-mail:          Web Site URL:    

No. of employees:            Total Sales for 2001:   

Year founded:

2.    Participant Information

 Title: Mr. Ms. Mrs. Dr.      First Name*        Last Name*:

                         Business Title: 

 Title: Mr. Ms. Mrs. Dr.      First Name        Last Name:

                         Business Title: 

3.    Travel Information

                                                Arrival Information

Date:    Airline    Flight#   Time:

                                                Departure Information

Date:    Airline    Flight#   Time:

4.    Information on Activities and Products of Interest

Principle activities of the Company or Institution

Industrial Goods and Commerce     Non-Profit Organizations

Service Industry                                 Finance and Investment

Import                                                   Export

4.1    Products of Interest

2/ Based on the list of sub-sector codes included on this page
3/ Please add the information considered relevant in the space provided

4.2    Additional comments on activities and/or products not mentioned above.