Registration Form: Europe 2020 Midterm Review - What track record? What opportunities?
25-26 September 2014
Brussels

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Surname *
First Name *
Organization   *
Country *
E-mail Address *
Buisiness Phone Number
Mobile Phone Number (In case of any problems)
Please give a short biography of yourself, including your job title and areas of interest related to the event and/or your work
ALSO: Please send a photo of yourself to office@eurodiaconia.org. This will be used for our participation list. We send out participation lists to all the participants of the event in advance to facilitate networking.
May we put your information on our participation list? *
Do you have any comments on/proposals for the agenda? Would you like to present your experience on any of the agenda items?
Date and time of arrival and mode of transport
This will help us in programming the meeting and to know if any travel problems have been experienced
Date and time of departure
Will you attend dinner on the 25th of September? *
Will you attend lunch on the 26th of September? *
 Please list any dietary restrictions or needs, e.g. allergies
Do you need Eurodiaconia to cover (part of) your travel costs?
Please read the reimbursement rules to see if you are eligible for financial support and please note that no travel should be purchased before you have received a confirmation from the Secretariat.
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If yes, please specify the amount.
Please note that only members from Eastern and Central Europe or a Diaconia from a minority Church can request financial support and that no travel documents should be purchased before you have received a confirmation from the Secretariat.
Would you like Eurodiaconia to book your accommodation with other participants? *
Do you need Eurodiaconia to cover the costs of your accommodation? *
Please note that only members from Eastern and Central Europe or a minority Church can request financial support for accommodation
May we use your information for our database? *
Your information will never be given to third parties
May we use photos taken during the event that may include you for our communications material? *
Would you like to receive our weekly e-newsletter? *
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