Registration Form
WTMC PhD workshop

On: 1-3 May 2017
Place: Soeterbeeck, Elleboogstraat 2, NL- 5371 LL Ravenstein
Phone: +31-(0)24-3615999

First name *
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Surname *
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Date of birth *
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Gender *
University/Organisation *
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Department *
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Postal address *
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Postal Code *
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City *
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Country
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Postal Address (if different from above)
If you want your reader to be sent to a different address
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E-mail address *
Please double-check your email address for any spelling errors.
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Are you a registred participant in the WTMC training program? *
If you are NOT a registred 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?
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If you are an external participant are you an EASST member
What is the topic of your research (5 lines)? *
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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 in box other?
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Hotel room reservation *
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Invoice address *
Address + budget or project or SAP number required by your organisation + contact person
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Remark/Question
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