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Registration form
This form informs the AfVT of your interest in participating in the VIII International Congress for Victims of Terrorism (CIVT) which will take place in Nice (France) on the 21st, 22nd and 23rd of November.
Last name *
Your answer
First Name *
Your answer
Nationality *
Your answer
Sex *
Date of birth *
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City of birth *
Your answer
Email *
Your answer
Phone *
Your answer
If applicable, the attack that concerns me and my story (in summary)
Your answer
Member of the organization (if applicable) and fonction
Your answer
I would like to speak during the congress (testimony, roundtable) *
Do you have any accessibility needs? If yes, please specify and explain how we can best accommodate your needs and we will follow-up with you.
Your answer
I agree to be interviewed, photographed and / or filmed and gives my right to the image in the framework of this congress (details on simple request to civt@afvt.org) *
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