IIPE 2017: Travel and Emergency Contact Form
If you are unable to complete this form online, you may download a word version at http://www.i-i-p-e.org/iipe2017/participants/travel/ and return it to info@i-i-p-e.org.
Email address *
CONTACT INFORMATION
Your contact information as you wish it to appear on the PARTICIPANT LIST.
First Name *
given name
Your answer
Last Name *
family name
Your answer
Organization / Affiliation
optional
Your answer
Country *
of origin or nationality - you may list more than one
Your answer
NAME TAG
Please provide your name and affiliation as you would like it to appear on your NAME TAG.
Name *
what you would like others to call you - may be formal or informal.
Your answer
Organization / Affiliation
optional
Your answer
HEALTH & DIET
Please indicate your dietary preference. *
Please note any food allergies or other dietary restrictions you might have:
Your answer
Health Conditions
Please indicate any health conditions the organizers should be aware of and the medicine you take for it (be sure to bring a full supply of any prescription medication)
Your answer
TRAVEL INFORMATION
Please provide your flight or other transportation details so we can track your anticipated arrival to Innsbruck. Providing your departing flight information is not essential, but will help us in making plans at the conclusion of the IIPE.
Arrival Information *
please choose one
If traveling via air, will you be using the shuttle service (provided by Four Seasons Travel) to arrive to the Grillhof Seminar Center?
If you are not using the shuttle service, how do you plan to get to the Grillhof Seminar Center?
Your answer
Arrival Flight Details
Airline
name of airline
Your answer
Flight number
Your answer
Plane is coming from:
(*If you will be changing planes on your trip, please provide details of the final flight that arrives to your destination)
Your answer
Arriving to what airport?
Date & Time of Arrival
MM
/
DD
/
YYYY
Time
:
Departing Flight Details
Airline
airline name
Your answer
Flight number
Your answer
Departing to:
Your answer
Departing from which airport?
Departure Date & Time
MM
/
DD
/
YYYY
Time
:
ACCOMMODATIONS
Accommodations at the IIPE are double occupancy. Please inform the organizers if you have a preferred rooming partner or any other special accommodation needs.

*Please note all single rooms have been distributed at this time.

rooming preference or other special accommodation needs
Your answer
EMERGENCY CONTACT INFORMATION
Please provide contact information of a person to notify in the event of an emergency.
Name *
Your answer
Relationship *
(mother, husband, wife, child, etc)
Your answer
Phone number *
Your answer
Email address: *
Your answer
BIO
Please provide us with a short biography to be included in the program.

Please no more than 50-100 words. DO NOT COPY AND PASTE YOUR CV INTO THIS FORM.

*If you have already submitted your bio with the program worksheet there is no need to provide it again.

BIO
Please briefly describe your background and the work you do.
Your answer
A copy of your responses will be emailed to the address you provided.
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