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Midlands 42 under 42 Awards 2012

Date: Thursday 14th June 2012
Venue: The Belfry Golf Course Hotel, Wishaw, Sutton Coldfield, West Midlands, B76 9PR
Enquiries: Lianne Sunderland – 0161 907 9741

Please note: Fields marked with * are compulsory fields and must be completed.

Title * -- Select -- Mr Mrs Miss Ms Doctor

Name *

Surname *

Position *

Company Name *

Type of Company * Accountants Architects Chemical Construction/Property Consultants Distribution/Retail Economic development Electronics Energy Industry Engineering Estate Agents Finance/Venture Capital Food Hotels/conferencing Information Technology Lawyers Local Government Manufacturing Marketing /media Medical Motors Recruitment Servicing Industry Stockbrokers Surveyors Telecoms Training & education Transport Travel & leisure Other

Address Line 1 *

Address Line 2

Town/City *

County

Postcode *

Phone *

Email *

Free Trial to Insider Magazine

If you would like to receive a free trial to Insider magazine, please ensure you fill out the "Form Completed By" and "County of Birth" fields, or we will not be able to process the request.

I would be interested in a free 4 month magazine subscription to Midlands Business Insider

Form Completed By
Required for auditing purposes

Please tell us the name of the first school you attended
Required for auditing purposes.

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