Registration Form WTMC Autumn Workshop "Open" 18-20 November, 2019

Meeting and Conference centre Soeterbeeck
Elleboogstraat 2, NL-5352 LP Deursen-Dennenburg
Phone: +31(0)24 3615999
Email address *
First name *
Surname *
Date of birth *
dd| mm| yyyy
University/Organisation *
Department *
Postal address *
Postal Code *
City *
Country
E-mail address *
Please double-check your email address for any spelling errors.
Are you a registered participant in the WTMC training program? *
If you are NOT a registered participant in the WTMC PhD training program, please indicate the following: 1. Department and university where you are registered to do a PhD; 2. Name of your PhD supervisor
What is the topic of your research (5 lines)? *
Do you want to give a presentation of your work? *
During this workshop 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, or projectnumber, or needed reference 2. Exact address for sending the invoice 3. Contactperson for sending the invoice *
Remark/Question
A copy of your responses will be emailed to the address you provided.
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