XIX CONGRESO LATINOAMERICANO DE PUERTOS MANTA 2010 REGISTRATION FORM

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XIX CONGRESO LATINOAMERICANO DE PUERTOS MANTA 2010 REGISTRATION FORM REGISTRATION FOR AAPA MEMBERS AND NON MEMBERS To register by email, please follow these steps: 1. Save this document in the desktop of your PC 2. Open the file you just saved. 3. Click on each of the spaces where you should fill out the required information. 4. After completing the Registration Form and verifying that the data provided is correct, save it again to protect the processed information. 5. Finally, send it by email, as an attachment to: inscripciones@congresomanta2010.com The amount to be paid is different for AAPA members and non members AAPA MEMBERS: $600 AAPA NON MEMBERS: $650 To register by FAX, we have the following number for your use: (+5932) 222 8438 For payment, you should make a money transfer from you bank to the organization s bank in the city of Quito-Ecuador with the following information: BANCO DEL PICHINCHA. TO THE ORDER OF: EXPOEVENTOS EXEV. CIA. LTDA ACCOUNT: 3411628804 SWIFT CODE: PICHECEQ For questions or assistance you can call: (+5932) 2 521 169 - (+5932) 2 2 556269 (+5939) 9 801 991 PERSONAL DATA First Name: (As it should appear in your identification card) Last Name: Company: Position: Address: City: State/Province: 1

Postal Code: Country: Telephone: Mobile phone: Fax: Email: Emergency contact: Emergency Telephone: INFORMATION FOR ACCOMPANYING PERSON First Name: As it should appear in the identification card Last Name: REGISTRATION FEES (*) Fees are shown in US Dollars PARTICIPANTS (*) Mark with an X AAPA Members US$ 600.- Non AAPA Members US$ 650.- REGISTRATION PAYMENT The following information is necessary to process your registration payment by any of the methods described below. OPTION 1: Payment by Bank Transfer (You should send this form by fax to: (+5932) 222 8438, together with a copy of your bank transfer or deposit) Bank Information for the Transfer Payment must be in US DOLLARS: a. Entity: BANCO PICHINCHA C.A. b. TO THE ORDER OF: EXPOEVENTOS EXEV.CIA.LTDA. c. ACCOUNT: 3411628804 d. SWIFT CODE: PICHECEQ For Payment in Ecuador: DIRECT DEPOSIT IN: BANCO PICHINCHA ACCOUNT: 3411628804 TO THE ORDER OF: EXPOEVENTOS EXEV CIA. LTDA. OPCIÓN 2: Payment with check (you should send this form by Courier, including your check) The Check must be to the order of: EXPOEVENTOS EXEV CIA.LTDA. 2

LODGING The following hotels have offered a special rate for the participants of the XIX Latin american Congress of Ports. The event organizer will provide the participants with courtesy transportation from these hotels to the conference and to all social activities. IMPORTANT: It is important to be aware that the number of rooms is limited, therefore, after June 20th we will not be able to guarantee available space. We recommend that you make your hotel reservations well in advance. Check In: 15,00 hours Check Out: 12,00 hours HOTEL Room Rate Services Hotel information ***** stars U$S 110.- SINGLE Deluxe Room www.oroverdehotels.com ORO VERDE MANTA HOTEL U$S 130.- It includes buffet breakfast, Pool, Gym & Spa. DOUBLE Deluxe Room AV MALECON CALLE 23 TEL 593.5.2629200 VENUE It includes breakfast buffet, Pool, Gym & SPA ***** stars HOWARD JOHNSON US$ 70.- SINGLE Room. It includes Buffet Breakfast, Pool, Gym, Sauna, Business Center. www.ghlhoteles.com K.M. 1.5 VIA BARBASQUILLO TE. 593.5.2629999 U$S 99.- DOUBLE Room It includes Buffet Breakfast, Pool, Gym, Sauna, Business Center. 10 MINUTES from the Venue HOTEL *** stars BALANDRA US$ 61.- SINGLE Room. It include breakfast and Health Club. www.hotelbalandramanta.com. AV. 7 Y CALLE 20 BARRIO CORDOVA TEL 593.52620545 U$S 70.- DOUBLE Room It include breakfast and Health Club. 4 MINUTES from the Venue HOTEL HOTEL YOU SELECTED: ROOM RATE: 3

SECOND OPTION HOTEL, IN CASE THE FIRST HOTEL YOU SELECTED DOES NOT HAVE ROOMS AVAILABLE: Please mark with an X your preferred option: Single Room Double ( 1 double bed) Double (twin beds) Date of arrival: Time of arrival (estimated): Date of departure: IMPORTANT: ALL RESERVATIONS MUST BE SUPPORTED BY THE PAYMENT OF THE FIRST NIGHT AT THE HOTEL. Please mark with an X your selected credit card and complete the information requested. Mastercard Visa American Express First and Last Name of the Card Holder: Expiration Date: Card Number: Security Code: Email: You will be contacted by a representative of you selected hotel by email to confirm your credit card payment. SOCIAL EVENTS Please mark with an X the solcial activities you plan to attend: Tuesday, July 6: Welcome Coctail in the Pool area of the Hotel Oro Verde Attire: We suggest dressing semi formal and light. Wednesday, July 7: Party / show at the beach. Bonfire and folklore presentation of Manta. Attire: We suggest dressing informally, with beach foot wear and white clothes. Thursday, July 8: Closing Dinner at the Yacht Club, International Night. Attire: For this evening we recommend dressing with elegant formal clothes. Friday, July 9: Official Closure. Visit to the Port. Departure at 15h00. Return at 17h00. 4

Lunch: Wednesday, July 7 Thursday, July 8 Friday, July 9 Attire during the academic sessions: We recommend dressing with informal business attire (sports coat). SPECIAL REQUIREMENTS Please let us know if you have a special diet or if you have some limitation in your food: Some other type of limitation, allegy or health condition: PROGRAM FOR ACCOMPANYING PARTICIPANTS For further information related to the excursions planned, please visit the web page www.congresomanta2010.com and open Programa Acompañantes. Your accompanying party may choose one or two of the following options we are offering. Please mark with an X your preference: Tour 1: Tour 2:. Tour 1. City Tour Manta - Montecristi Duration of tour: 2 hours Meeting guests in the hotel assigned. Panoramic view of the city. Visit the ship yard and the little beach as it is known, a distribution center where you find fishermen trading their products. Visit the Tagua Store (At time of production) to see the development of handcrafts made with this product, highly valued in European markets and also called vegetable ivory. Visit the archaeological museum of Manta, a wide display of pre-columbian cultures of the Ecuadorian coast. Travel to Montecristi, birthplace of General Eloy Alfaro Delgado. Walk the main streets. Free time for shopping and visit the workshops where artisans very skillfully produced the toquilla straw hats. Visit the museum Alfaro: Ecuador s first liberal president. Visit the Basilica of the Virgin of Monserrate Tour 2. Hacienda San Antonio Duration of tour: 4 hours approx. Exit onto the coastal road. On the way to the forest Pacoche find the tropical dry forest, with its distinctive tree, palo santo and ceibo. Just 26 kilometers will be on 390 meters above sea level, entering a rain forest and cloud at certain times of the year. From August to October Visit the animal rescue center, brief exposure of the preparation of the toquilla straw hats. Typical welcome cocktail Prepare horses for short rides (optional) 5