Pre-registration form
Personal Information
Title: *
First Name: *
Your answer
Last Name: *
Your answer
Date of birth:
MM
/
DD
/
YYYY
Company / Organisation / Institution *
Your answer
Position *
Your answer
Country *
Where you are currently based
Your answer
Contact Number: *
Please include country and area codes
Your answer
Contact Email Address: *
Your answer
Postal Address
Number/Floor - Building/Street/Suburb/Postal code/Country
Your answer
Preferred Contact Method *
Useful links - Current Project/s
Links to your professional/personal projects for further relevant information about yourself or your institution
Your answer
Event Participation
Conference Attendance: *
Please indicate the details of your attendance.
Participation in Conference Workshops: Session 1 *
Please indicate the workshop you wish to participate in - please note that this is not the definitive registration for the workshops..
Participation in Conference Workshops: Session 2 *
Please indicate the workshop you wish to participate in - please note that this is not the definitive registration for the workshops.
Gala Evening, October 11th 2013 - From 8pm *
Please indicate your interest to participate in this social gathering after Day 1 of the conference. Please note that this event is not yet finalised in the program and may be subject to cancellation.
If yes, will you be accompanied?
(One person extra max)
Comments
Any useful comments are very welcome !
Your answer
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