Practice Peace: Registration Form
28.10.–03.11.2017 / 03.02.–08.02.2018
Name and Surname
Your answer
Country of Residence
Your answer
Current City
Your answer
Gender (This information is necessary for the assignment of rooms)
Your answer
Date of Birth (The information is relevant to assure an intergenerational mix of the group)
MM
/
DD
/
YYYY
Email
Your answer
Phone number
Your answer
Occupation / Organisation / Background
Your answer
Diet
Required
Comments regarding your diet (e.g. allergies)
Your answer
Other needs (wheelchair access, medication, …)
Your answer
What is your personal/professional background and how is it related to the topic of the training?
Your answer
What is your motivation to participate?
Your answer
Is there anything else we should know?
Your answer
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