Request edit access
Final Conference on “Reducing Health Inequalities Experienced by LGBTI People”
February 1st & 2nd, 2018 - Brussels, Belgium;
(external stakeholders)
Email address *
Last Name *
Your answer
First Name *
Your answer
Organisation *
Your answer
Title (e.g. Director, Project Manager) *
Your answer
Your answer
I confirm that I will attend the conference: *
Do you have any specific needs, such as reduced mobility or dietary restrictions?
Your answer
Personal information for Access to the Final Conference
The venue for the conference has not yet been confirmed. It may, however, take place at the European Committee of the Regions. If that is the case, the information below will be required from all the participants to the conference.
Nationality *
Your answer
Date of Birth *
Passport or Identity Card *
Number of the passport or identity card *
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms