virtualWOMEX registration form
Fill in this form and submit it to become an active member of the virtualWOMEX network.

Attention: This form is for registration to virtualWOMEX only! If you want to register for WOMEX 12, please visit this page.

I / we register for virtualWOMEX:
name of company or individual
website
address
city code
city
country
general phone
general fax
general e-mail
If your company is based in the European Union: VAT identification number
This form allows the registration of maximum 3 persons per company.
1. PERSON
last name
first name
function
direct phone
direct e-mail
2. PERSON
last name
first name
function
direct phone
direct e-mail
3. PERSON
last name
first name
function
direct phone
direct e-mail
Please tick your company´s activities:
ARTIST
agent/booker
band/soloist
composer/songwriter         
dj
manager
MEDIA
multimedia prod.
online
photo
print
publicity/pr
radio
tv
video/film prod.
PUBLISHER
books
music
RECORDS
distribution
label
manufacturing
producer
studio
TRADE
mail order
online-shop
retail
wholesale
INSTITUTION
cult. inst.
educational
governmental
library/archive
network
non-governmental
research
PROMOTER
conference
concert promoter
festival
tour
trade fair
special event/award
venue/club
SERVICES
accomodation
advertising
catering
computer/online
consultant
design/artwork
engineer
equipment
instruments
legal/bookkeeping
merchandising
security
transport
Payment possible via credit card only!
rate  
for 6 months EURO 55 (VAT of 19% may apply - see the General Terms below)  
for 12 months EURO 99 (VAT of 19% may apply - see the General Terms below)
Credit card (please tick)
AMEX  
MASTERcard/EUROcard
VISA
expiry date month   year    
card number  
CVV2/CVC2 What is 'CVV2/CVC2'?  
name on card  
General Terms
  • The minimum participation period is 6 months.
  • The fee for a 6 months period of use is 55 Euro.
  • The fee for a 12 months period of use is 99 Euro.
  • A value added tax (VAT) of 19% applies:
    • if you are resident in Germany;
    • if you are resident in the European Union and do not have a VAT number.
    In such cases, the fee is:
    • 65,45 Euro for use over a 6 months period;
    • 117,81 Euro for use over a 12 months period.
  • Please take notice of the exchange rates.
  • Payment exclusively with credit card (AMEX, Visacard, Mastercard).
  • Termination of contract is possible at any point up to the last month before the participation period expires (informal notice of cancellation to be sent to virtual@womex.com, only valid with a confirmation from virtualWOMEX); otherwise your membership will be extended automatically.
  • Please allow us a few hours to process your registration and build up your account.
  • This contract is based on our General Terms of Business.
  • For any questions concerning the registration process of virtualWOMEX please contact us at virtual@womex.com.
  • This form will be sent via e-mail through a secure connection.
    You can also fill and print it out and:
    • fax it to: +49 30 318 614 10
    • or send it via snail mail to:
      piranha womex AG
      Bergmannstr. 102
      10961 Berlin
      Germany
Terms Of Payment
  • All prices to be paid in Euro currency only.
  • The registration is valid only with a completed registration form
  • virtualWOMEX will not be held responsible for any third party liability incurred by participants as a result of any alteration of format, date and location of the website.
  • Any cancellation must be sent via e-mail to virtual@womex.com.
  • The registration includes the building up of a profile for your company as well as one for each of its registered delegates in virtualWOMEX access to all areas of virtualWOMEX and the right to submit data into virtualWOMEX.
  • This contract is based on our General Terms of Business.
I am aware that I agree to the virtualWOMEX terms of payment
anytime I click on the "submit" button below to send an order using this mailform!