Exhibitor & Sponsor form The information provided in this form will be published on the ITU Telecom World 2017 Exhibitor & Sponsor Listing webpage in June and in the event app in August. This is your opportunity to provide other event participants with interesting, relevant and useful information on your company, country or organization and its activities for networking purposes and to set up meetings with you onsite. Please complete and submit the form as soon as possible. Please note that all fields marked with * are mandatory. Company information Company/Organization name * Country * Please selectAdelie LandAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanAzoresBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBrazilBritish Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCanary IslandsCayman IslandsCentral African Rep.ChadChagos IslandsChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Rep. of the)Cook IslandsCosta RicaCôte d'IvoireCroatiaCrozetCubaCuraçaoCyprusCzech Rep.Dem. People's Rep. of KoreaDem. Rep. of the CongoDenmarkDiego GarciaDjiboutiDominicaDominican Rep.Easter IslandEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong Kong, ChinaHowland IslandHungaryIcelandIndiaIndonesiaInternationalIran (Islamic Republic of)IraqIrelandIsraelItalyJamaicaJapanJarvis IslandJohnston IslandJordanKazakhstanKenyaKerguelenKiribatiKorea (Rep. of)KuwaitKyrgyzstanLao P.D.R.LatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao, ChinaMadagascarMadeiraMalawiMalaysiaMaldivesMaliMaltaMarion IslandMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMidway IslandsMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepal (Republic of)NetherlandsNetherlands CaribbeanNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianasNorwayOmanPakistanPalauPalmyra IslandPanamaPapua New GuineaParaguayPeruPhilippinesPhoenix IslandsPitcairnPolandPortugalPuerto RicoQatarReunionRodriguesRomaniaRussian FederationRwandaSaint BarthelemySaint Kitts and NevisSaint LuciaSaint Paul and AmsterdamSaint Pierre and MiquelonSaint Vincent and the GrenadinesSaint-MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSt Helena, Ascension and Tristan da CunhState of PalestineSudanSurinameSwan IslandsSwazilandSwedenSwitzerlandSyrian Arab RepublicTajikistanTanzaniaThailandThe Former Yugoslav Rep. of MacedoniaTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and CaicosTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaViet NamWake IslandWallis and FutunaWestern SaharaYemenZambiaZimbabwe Company Description * (max 200 words): Company Logo * (jpeg/gif/png format) Do you identify your company as an SME? * YesNo Company Details Company Address * (street/PO box, ZIP code, city) Company Telephone * (country/area/number) Company Email * Company Website * Links to relevant video (Youtube or Vimeo) Social Links: Facebook Twitter Linkedin Other Contact Person Please provide the name of someone from your company or delegation who will be present at the event. Other event participants can then use these details to ask for more information on your organization or request a meeting with you at the event - a great opportunity to promote your stand, network and connect directly. Can we publish these details on the website and app? * YesNo Title* MrMsDrProf First Name* Last Name* Job Title * Telephone (country/area/number) Mobile (country/number) Email * Stand Activity Use this section to engage with your audience by providing as much information as possible on what event participants can do, see, discuss and find out about on your stand. Who can they meet, what projects or initiatives are you showcasing, when are you planning presentations or demos? This is your chance to start promoting your event presence! Stand Focus * Smart health5GIOTUniversal accessSMEs/ICT ecosystemTrust and Smart citiesAISmart financeSmart educationTrust and securityOther Other (please specify) Why should Exhibition visitors come to your stand? (max 200 words): Activity: Brief description: Date: Time: If you are participating with a National or Thematic Pavilion, please fill in the details below: Pavilion Name Please selectAzerbaijan PavilionCameroon PavilionGabon PavilionGhana PavilionIndonesia PavilionITU-BR&BDT PavilionKorea PavilionMalawi PavilionNigeria PavilionPhilippines PavilionRwanda PavilionSenegal PavilionSouth Africa PavilionZimbabwe Pavilion Your Stand Name inside the Pavilion Your Stand Number By submitting this form to ITU, the Exhibitor/Sponsor/Pavilion Member hereby represents and warrants to ITU that the information contained in this form is true, accurate and complete in all material aspects and it does not contain any untrue or misleading information. The Pavilion Member additionally represents and warrants that it has already been accepted by the Pavilion Organizer to participate within the above-mentioned Pavilion. ITU reserves the right to refuse participation to any Exhibitor/Sponsor/Pavilion Member in breach of the aforementioned representations and warranties.