REGISTRATION TO THE ICORN GENERAL ASSEMBLY, Malmö 2-4 May 2018
Registration form
Email address *
First Name *
Your answer
Surname *
Your answer
Cell phone number (incl. international code) *
Your answer
Nationality *
Your answer
City of Residence *
Your answer
Are you *
Which organisation/institution do you represent
Your answer
Date of arrival *
MM
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DD
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YYYY
Date of departure *
MM
/
DD
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YYYY
Do you have any dietary requirements (if yes, please specify) *
Your answer
Do you have any disabilities that we need to be aware of? If yes, please specify. *
Your answer
Are you bringing a partner/friend that you will be sharing room with? If yes, please specify with whom (accompanying person must also register separately). Which nights will accompanying person stay? *
Your answer
In Case of Emergency Contact Information: Name of person(s) to be alerted, and phone number(s) (with international code) *
Your answer
Invoice details: Recipient, invoice reference, surface address AND e-mail *
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A copy of your responses will be emailed to the address you provided.
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