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3E seminar registration form

If you have any special request - such as a request for travel reimbursement, programme contribution proposal etc. please fill in the Additional comments/requests field.
Required fields are marked with an asterisk (*)

Name *
Date of birth*
Address*
Email *
Telephone*
Member status (organization/individual)*
Name of the member organization*
Accomodation needed (specify the dates)*
Dietary request (vegetarian/vegan)*
Visa needed (yes/no)*
Registration fee payment method (by a credit card before arrival/cash upon arrival)*
Will you take part in the Network's AGM on Sat. 7 Nov.? (yes/no)*
Additional comments/requests

 
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 This page was last updated 19 October 2009