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| ![](media/image1.wmf)            |   |                                  |
|                                  |   |                                  |
| # USCS India Cement I            |   |                                  |
| ndustry Trade Mission to the U.S |   |                                  |
|                                  |   |                                  |
| # Concurrent with                |   |                                  |
|                                  |   |                                  |
| # Fift                           |   |                                  |
| h APP Cement Task Force meeting  |   |                                  |
|                                  |   |                                  |
| #                                |   |                                  |
|                                  |   |                                  |
| # May 10 -- 18, 2008             |   |                                  |
|                                  |   |                                  |
| # Charleston, South Carolina USA |   |                                  |
|                                  |   |                                  |
| # [Del                           |   |                                  |
| egate Questionnaire]{.underline} |   |                                  |
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| Please clearly print or type     |   |                                  |
| your answers and return with a   |   |                                  |
| copy of your resume or CV        |   |                                  |
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| Dr. Mr. Ms. Mrs                  |   | Family Name:                     |
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| Middle Name:                     |   | First Name:                      |
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| Professional Information         |   |                                  |
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| Organization and Department:     |   |                                  |
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| Organization Address:            | D |                                  |
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| Organization Type:               |   |                                  |
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| NGO Government Private           |   |                                  |
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| Personal Information             |   |                                  |
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| Home Address:                    | H |                                  |
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| Passport Number:                 | C |                                  |
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+----------------------------------+---+----------------------------------+
| **Your company can be best       |   |                                  |
| described as:**                  |   |                                  |
|                                  |   |                                  |
| Manufacturer Distributor         |   |                                  |
| Engineering consultants          |   |                                  |
| Contractor                       |   |                                  |
|                                  |   |                                  |
| Other (Please specify)...        |   |                                  |
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| **Please select from the         |   |                                  |
| categories below which best      |   |                                  |
| describe your needs and          |   |                                  |
| interests:**                     |   |                                  |
|                                  |   |                                  |
| Equipment ( ) Technology ( )     |   |                                  |
| Services ( )                     |   |                                  |
|                                  |   |                                  |
| **Please explain your needs -**  |   |                                  |
|                                  |   |                                  |
| **\_\_\_\_\_\_\_\_\_             |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
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| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_** |   |                                  |
|                                  |   |                                  |
| **\_\_\_\_\_\_\_                 |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_** |   |                                  |
|                                  |   |                                  |
| **\_\_\_\_\_                     |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
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| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_** |   |                                  |
|                                  |   |                                  |
| **\_\_\_\_\_\_\_                 |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
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| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_** |   |                                  |
|                                  |   |                                  |
| **Do you have a relevant project |   |                                  |
| for presentation in this         |   |                                  |
| mission?**                       |   |                                  |
|                                  |   |                                  |
| **If yes, please provide a brief |   |                                  |
| of the project. (Please attach a |   |                                  |
| separate sheet if required)**    |   |                                  |
|                                  |   |                                  |
| \_\_\_\_\_\_\_\_                 |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
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| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
|                                  |   |                                  |
| **Would you like to meet with    |   |                                  |
| individuals from (mark boxes as  |   |                                  |
| appropriate):**                  |   |                                  |
|                                  |   |                                  |
| Business                         |   |                                  |
| Organizations/Associations       |   |                                  |
| Research & Academic Cement       |   |                                  |
| Manufacturers Cement Industry    |   |                                  |
| Technology Suppliers Consultants |   |                                  |
| Agents                           |   |                                  |
|                                  |   |                                  |
| **Please provide any other       |   |                                  |
| information that might help us   |   |                                  |
| make this match more             |   |                                  |
| productive.**                    |   |                                  |
|                                  |   |                                  |
| \_\_\_\_\_\_                     |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
|                                  |   |                                  |
| **What type of results do you    |   |                                  |
| expect from this mission?**      |   |                                  |
|                                  |   |                                  |
| Technology transfer Agent /      |   |                                  |
| distributor Joint venture /      |   |                                  |
| Licensing Consulting Services    |   |                                  |
| opportunities Equipment          |   |                                  |
| purchase.                        |   |                                  |
|                                  |   |                                  |
| **Other** (Please                |   |                                  |
| specify)...**\_\_\_\_\_\_        |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |   |                                  |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_** |   |                                  |
+----------------------------------+---+----------------------------------+
|                                  |   |                                  |
+----------------------------------+---+----------------------------------+
| **For your air travel and hotel  |   |                                  |
| arrangements, please contact:**  |   |                                  |
|                                  |   |                                  |
| Mr. Mukesh Mehta                 |   |                                  |
|                                  |   |                                  |
| Globe Tours & Travels            |   |                                  |
|                                  |   |                                  |
| F-109-110, Aman Chambers,        |   |                                  |
|                                  |   |                                  |
| 47/21-22, Old Rajinder Nagar     |   |                                  |
|                                  |   |                                  |
| New Delhi 110 060                |   |                                  |
|                                  |   |                                  |
| Tel: 91-11-2581 5329, Mobile#    |   |                                  |
| 9810056503                       |   |                                  |
|                                  |   |                                  |
| Fax: 91-11- 470 18231, Email:    |   |                                  |
| [g                               |   |                                  |
| lobetours@gmail.com]{.underline} |   |                                  |
|                                  |   |                                  |
| [www.globeexhibitions.com](h     |   |                                  |
| ttp://www.globeexhibitions.com/) |   |                                  |
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