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Sponsorship application

Thank you for considering Servier BELUX for your event sponsorship

 

Please submit your application in full. This will help us establish the agreement and process it efficiently, transparently and in compliance with applicable regulations.

We need the following information from you:

  • a contact person, including title, full name, email address and telephone number
  • full details about your institution, with its legal name and address, the field of study, as well as bank details and VAT/company number and bylaws
  • event details, with date, program, public, MDEON visa if applicable, sponsor possibilities and counterparts
  • agreement signatories (up to 5): name, function and email address

Note: you will need to upload:

  • the program for the event you are requesting sponsorship (as a PDF, 5Mb size limit)
  • the sponsor possibilities and counterparts (as a PDF, 5Mb size limit)
  • your institution bylaws / legal status (as a PDF, 5Mb size limit)

If you have further questions or technical difficulties, you can contact us:

by phone on +32 (0)2 529 43 11

by email at information.belux@servier.com

ENTER YOUR DETAILS HERE

Fields marked * are mandatory

    CONTACT PERSON
    INSTITUTION
    EVENT
    Who is the audience?*
    Event start date*
    How long does the event last?*
    Invoice will only be paid if the MDEON visa number is communicated
    ATTACHMENTS
    Event program*
    Sponsoring possibilities and counterparts*
    Institution bylaws*
    Other
    LEGAL REVIEW
    YES NO
    SIGNATORIES - The agreement established by Servier will be sent via DocuSign