Pre-registration form - ENCePP Plenary - 21 November 2017
This form serves for the pre-registration of the nominated representative/s who shall receive an invitation to the ENCePP Plenary meeting.

Please pre-register by submitting this form completed with the name and contact details (email address) of the nominee. The official invitation will be sent directly to the nominated invitee.

Date, time and location of Plenary
Tuesday, 21 November 2017, 9.30-16.30
European Medicines Agency, 30 Churchill Place, Canary Wharf, London E14 5EU
Important information
The ENCePP Secretariat can only accept nominations to attend the ENCePP Plenary meeting from research centres and networks that have joined ENCePP (ENCePP partners) by registering in the ENCePP Database of Research Resources.

The reimbursement of travel expenses will be granted to the first 65 non-for-profit organisations confirming their attendance at the Plenary. Only one representative per registered research centre or network will be eligible for reimbursement. In case you nominate more than one representative, please use one form per person and indicate who will be the reimbursed delegate.

Given funds are limited, the following priorities will be applied to determine reimbursement to delegates whose requests for reimbursement to attend the Plenary were received before the cut-off date (see 'Deadline')

1. Speakers (unless they are members of EC, other EU agencies or industry)
2. Steering Group members or Chairs of Working Groups
3. Working Group members

Remaining funds for other representatives will be allocated on a first-come first-served basis.

Note: 'for-profit' status is determined as indicated by ENCePP partners in their entries in the ENCePP Database of Research Resources.

Last name *
Your answer
First name *
Your answer
Country *
Representing *
Please provide full name of ENCePP partner (centre/network)
Your answer
E-mail *
Your answer
Participant is to be reimbursed *
Please indicate whether reimbursement of travel expenses is requested (see section 'Important information' for reimbursement priorities)
Participant is the only representative from this research centre or network attending Plenary *
Are you a member of any ENCePP WG/SIG? *
If you are a member of ENCePP WG/SIG, which one?
Your answer
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