Assistance 2017
Register here for a place to sleep during the 2017 EC Summer Course for medical reasons
Please note application does not guarantee a place.
Email address *
Full name *
Your answer
Street + house/flat number *
Your answer
Country *
Your answer
Telephone number (inc. international dialling code) *
Your answer
Medical reason *
Your answer
Medication since *
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Arrival date *
MM
/
DD
/
YYYY
Departure date *
MM
/
DD
/
YYYY
Mobility & assistance
Please complete the captcha before submitting the form.
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