Registration Form
MedSpring Annual Meeting of the General Assembly and Final Conference

Brussels (BE) 6-7 July 2017

Title
Required
Family name (as reported in your passport):
Your answer
First name (as reported in your passport):
Your answer
Name of Organization / Institution:
Your answer
Country:
Your answer
Nationality:
Your answer
Mobile Phone No.
Your answer
Office Phone No.
Your answer
e-mail:
Your answer
Need VISA
Required
Need invitation letter
Please inform us immediately if you need an official invitation letter to get the VISA
Required
In case you need a VISA, please provide us with your passport number
A scanned copy of the passport need to be sent to medspring@iamb.it
Your answer
Passport expiry date
MM
/
DD
/
YYYY
Social events
Do you participate to the Social Dinner (6 July) and Networking Lunch (7 July)?
DEADLINE & CONFIRMATION
CONFIRMATION DEADLINE : within 31 May 2017
FOR DIRECT CONTACTS
MedSpring Coordination Staff
CIHEAM- Mediterranean Agronomic Institute of Bari
Email: medspring@iamb.it
NOTE
Please note that each partner will organize and cover the costs for travel and accommodation.
CIHEAM-Bari will cover working buffets and social dinner.
Thank you for your collaboration!

The MedSpring Coordination Staff

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