Registration Form - EMSA European Week of Ethics 2017
16th - 20th February 2017, Kaunas/Lituania
Name
Your answer
Surname
Your answer
Date of birth
MM
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DD
/
YYYY
E-mail-address
Your answer
Country
If your country was missing from the list above, please specify it here
Your answer
Faculty Member Organisation (FMO)
If your FMO or organisation was missing from the list above, please specify it here
Your answer
Your position in EMSA at the time of EWE 2017
Nationality
e.g. Georgian
Your answer
Phone number
Don't forget to add your country code, e.g. +90 for Turkey
Your answer
Your planned arrival date
MM
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DD
/
YYYY
Your planned arrival time
Time
:
Your planned departure date
MM
/
DD
/
YYYY
Your planned departure time
Time
:
Emergency contact
Name, relation and phone number of your emergency contact
Your answer
Your level of English
Estimate your English level for us (no certificate is requested, we just want to get an overview of our participants’ average English level)
Have you ever attended an EMSA European meeting? If yes, please specify the name of the meeting(s):
Your answer
What is your motivation to attend the European Week of Ethics 2017? (Your motivation letter will be considered for the selection process and has a limit of 250 words.)
Your answer
Do you need an invitation letter?
Do you want to attend the meeting with or without accommodation?
What means of payment would you like to use for the fee?
PayPal requires an extra fee of around 7€ (or 4€ without accommodation).
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