Registration Form WTMC Summer School 26-30 August, 2019

Meeting and Conference centre Soeterbeeck
Elleboogstraat 2, NL-5352 LP Deursen-Dennenburg
Phone: +31(0)24 3615999
Email address *
First name *
Your answer
Surname *
Your answer
Date of birth *
dd| mm| yyyy
Your answer
University/Organisation *
Your answer
Department *
Your answer
Postal address *
Your answer
Postal Code *
Your answer
City *
Your answer
Country
Your answer
E-mail address *
Please double-check your email address for any spelling errors.
Your answer
Are you a registered participant in the WTMC training programme? *
If you are NOT a registered participant in the WTMC PhD training programme, please indicate the following: 1. Department and university where you are registered to do a PhD; 2. Name of your PhD supervisor?
Your answer
If you are an external participant are you an EASST member? *
Required
What is the topic of your research (5 lines)? *
Your answer
Do you want to give a presentation of your work? If so, then you will be asked for a title and for an abstract. *
During this Summer School all meals are vegetarian *
If you have any special dietary needs, please specify them below.
Required
Hotel room reservation *
Required
For sending the invoice, please give following details accurately: 1. Your budgetnumber/projectnumber/reference 2. Exact address for sending the invoice 3. Contactperson for sending the invoice *
Your answer
Remark/Question
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service