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PMC 2018 Official Registration Form
Prague Model Congress - International U.S. Congress Simulation in the Czech Republic, 1-2 December 2018
Email address *
Cell phone
(international format)
Your answer
Register *
Delegation Leader's name
(in the case of Delegation Participant registration, please state the Delegation Leader's name below, otherwise skip this question)
Your answer
Surname *
(as in the Passport or ID)
Your answer
Forename(s) *
(as in the Passport or ID)
Your answer
Country *
(as in the Passport or ID)
Your answer
Institution
Your answer
Preference 1 - Committee *
Preference 1 - Role *
Preference 2 - Committee *
Preference 2 - Role *
Preference 3 - Committee
Preference 3 - Role
Dietary requirement *
(regarding Saturday's and Sunday's Lobbying Lunches and Sunday's Dinner)
Elective Workshops
(please indicate which Elective Workshops you wish to attend)
Your answer
Notes / Questions
Your answer
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