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Registration Form WTMC Autumn Workshop "Open" 18-20 November, 2019
Meeting and Conference centre Soeterbeeck
Elleboogstraat 2, NL-5352 LP Deursen-Dennenburg
Phone: +31(0)24 3615999
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Email
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Your email
First name
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Your answer
Surname
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Date of birth
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dd| mm| yyyy
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University/Organisation
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Department
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Postal address
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Postal Code
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City
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Country
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E-mail address
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Please double-check your email address for any spelling errors.
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Are you a registered participant in the WTMC training program?
*
Yes
No
If you are NOT a registered 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
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What is the topic of your research (5 lines)?
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Do you want to give a presentation of your work?
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Yes
No
During this workshop all meals are vegetarian
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If you have any special dietary needs, please specify them below.
No special needs
Other:
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Hotel room reservation
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Check in on Monday, 18 November 2019
Check out on Wednesday, 20 November 2019
Other:
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For sending the invoice, please give following details accurately: 1. Your budgetnumber, or projectnumber, or needed reference 2. Exact address for sending the invoice 3. Contactperson for sending the invoice
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Remark/Question
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A copy of your responses will be emailed to the address you provided.
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