Nestle Middle East FZE H.Q.

building, 3rd floor DWC Office park Logistics city Dubai World Central United Arab Emirates Postal Address: P.O Box 17327

Lower Gulf Symposium

Abu Dhabi -Yas Island, Crown Plaza Hotel

The First 1000 Days

Paving the way for healthier generations
From 1 to 2ndFeb., 2013
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SPEAKERS AGREEMENT
______________________________________________________________________________________________________

In order to participate in this NNI-ME symposium as a Speaker, kindly complete the information below, sign this Agreement , scan and return it by email to Dr. Hanan Anwar.

Please tick the appropriate box(es)

Title

xx

Dr.

Prof.

xx

MD

PhD.

(Please type or fill out the form with capital letters)

First name(s) Family name Professional Address (NOT P.O. BOX PLEASE) Telephone Fax E-mail rtras5@yahoo.com Mohammad Cheikhali Al Rahba hospital , Abu Dhabi

050 9092857

The parties to this Agreement areDr. M.R. Cheickaliand the NESTL NUTRITION INSTITUTE (NNI) Middle East (ME). By your signature below, you accept the terms of this Agreement and the terms of the emailin which this Agreement was sent, which originated fromDr. Hanan Anwar on behalf of NNIME. The Email is considered part of this Agreement. Honorarium Your will receive your honorarium after the congress. Kindly ask you to fill in your bank account information (form attached) and send it back with this agreement to Dr. Hanan Anwarmax. 1 week before the Symposium time.

Service Honorarium in USD Attending and presenting*Lower Gulf Symposium750.00 per lecture In consideration of NNIs agreement to cover the Travel and Accommodation expenses, as well as the honorarium, described in the Email, you agree as follows:
1) To prepare a presentation on the topic agreed with the congress Committee and as dedicated in the program. . That NNI may video tape your presentation and that the video and slide presentation (as PDF) may be placed for the congress participants and/or used by the NNI on its Websitefor educational purposes only.

2)

NNI intends the satallite Symposium to be conducted in accordance with the highest professional ethics. By signing below, you acknowledge that the purpose of the lectures are purely educational and that there is no expectation that you will recommend or prescribe products produced by the affiliates of NNI. Please note that your agreement to participate and NNIs agreement to cover the costs and fees described above and/or in theagreement , as well as the honorarium referenced in agreement , is valid only under condition that you participate at the congress and provide us with the presentation within the deadline requested above.

By signing below, you indicate your acceptance of the above terms.

YES x

NO I agree that my ppt presentation (pdf version only) can be given to those workshop participants who specifically request it.

Place & Date Abu Dhabi, Jan 15, 2013 _____________

Signature M cheikhali ___

Lower Gulf Symposium

Abu Dhabi -Yas Island, Crown Plaza Hotel

The First 1000 Days

Paving the way for healthier generations
From 1 to 2ndFeb., 2013
BANKING INFORMATION FOR PAYMENT
st

Bank Name: Abu Dhabi commercial bank Address Line 1: Al Salam Rd Address Line 2 : City : Abu Dhabi Postcode : 00000 Country : UAE

Account Holder : mohammad raed cheikhali Account Number : 793179132001 IBAN Number/Swift : AE170030000793179132001

Sort Code/Routing Number :

ADCBAEAA