Individual Registration Form CTC 2023

Do you want to participate in the Dutch CleanTech Challenge 2023?

Through registering here you will have the chance to develop a sustainable startup and compete with other students in this year’s CleanTech Challenge.

The information you provide is confidential and will not be shared with the public. Please answer all questions truthfully. 

When you are still looking for a team as an individual participants or to complete existing your team, there will be a speed dating event on January 19th! 

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First Name *
Surname  *
Gender *
Date of Birth *
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/
DD
/
YYYY
Nationality *
Phone Number

*
E-mail address *
LinkedIn URL *
Home Address *
Postal Code *
City *
Name of University or Educational Institution *
Type of Study Program *
If other, please specify
Name of Study Program *
Study Phase *
If other, please specify
How did you find out about the Dutch CTC Challenge?
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Why do you want to participate in the Dutch CTC Challenge? *
If you already have a team, please list the names of the team members below (max. 5 members per team) (Note: the team members must all register individually)
Do you have any dietary restrictions?  *
If yes, please specify
Emergency contact information (first name, last name, phone number, e-mail address) *
Are you able to join the speed dating event on January 19th? (starts around 17.00)
Clear selection
Terms & Conditions
1) By filling out this form you consent for your information to be used by the Dutch CTC 2023 Committee. 
2) By filling out this form you consent to receive updates & notifications regarding the Dutch CTC 2023. 
3) By filling out this form you declare that you want to participate in the Dutch CTC 2023.
4) By filling out this form you declare that the information you provided is accurate and truthful.  


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