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BJA 60th Anniversary Event
Belgian-Japanese Investments – Past, Present and Future

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										<strong>Participant</strong>
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										<a class="remove-event-participant"><i class="fa fa-user-slash"></i> remove participant</a>
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										<label>First name<span class="req">*</span></label>
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										<label>Last name<span class="req">*</span></label>
										<input name="participants[lname][]" type="text" value="" />
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										<label>Function</label>
										<input name="participants[function][]" type="text" value="" />
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										<label>E-mail<span class="req">*</span></label>
										<input name="participants[email][]" type="text" value="" />
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											<label>Category<span class="req">*</span></label>
											<select name="participants[category][]" style="width: 100%;">
											
												<option value="BJA Members">&euro; 40.00 -- BJA Members</option>
												
												<option value="Non-members">&euro; 80.00 -- Non-members</option>
												
											</select>
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											<label class="small-line-height">Would you like to attend the guided tour of the imec Cleanroom (limited number)? YES/NO<span class="req">*</span></label>
											<textarea name="participants[subs_custom_field_01][]" rows="4"></textarea>
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