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Europe 3.0 - Registration Form
Creating a European Media Space in the heart of Brussels!
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* Indicates required question
First name
Your answer
Last name
Your answer
Gender
Male
Female
Other:
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Date of Birth
Your answer
Country of residence
Your answer
Citizenship
Your answer
ID/Passport number
Please specify whether it is ID or Passport
Your answer
Postal address
Your answer
Phone number
Don't forget your country prefix
Your answer
Email address
Your answer
Email address
Please repeat your email address
Your answer
Special needs
Do you have any special needs or requirements that the organisers should take into account (e.g. dietary, disability, etc.)?
Your answer
Visa
If you are accepted as a participant on this course, will you require assistance in obtaining a visa to Belgium?
Yes
No
Are you a JEF Member?
*
Yes
No
Required
If yes, please state your section and function:
Your answer
Relation to the theme of the training days
What is your personal/professional experience in relation to the theme of the TC?
Your answer
What do you expect to learn during this TC? What are your main expectations?
Your answer
Do you have ideas for possible activities that you would like to implement after this TC? If yes, please, briefly describe them.
Your answer
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