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


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First name *
Surname *
Date of birth *
dd| mm| yyyy
Gender *
University/Organisation *
Department *
Postal address *
Postal Code *
City *
Country
Postal Address (if different from above)
If you want your reader to be sent to a different address
E-mail address *
Please double-check your email address for any spelling errors.
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?
If you are an external participant are you an EASST member
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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 in box other?
Required
Hotel room reservation *
Required
Invoice address *
Address +  budget or project or SAP number required by your organisation + contact person
Remark/Question
Submit
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