3rd Annual Meeting Registration Form

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23 - 24 September 2022 (Lisbon, Portugal)

Location: VIP Executive Art's Hotel

Email *

Name *

Another e-mail contact (if different from the one use to fill in this form):

Institution *

University of Amsterdam

Sapienza University of Rome

University of Lund

iMM

Other:

Position *

Master Student

PhD Student

Post-doctoral researcher

Senior Researcher

PI / co-PI

Lab manager / Lab technician

Other:

Scientific tutor *

If you are a student, a PhD student or a Postdoc, please, ask for approval of your tutor/supervisor before registering. Please, write the name and e-mail of your tutor bellow. If it does not apply to your case, write: does not apply.

Will you bring a poster to present at the annual meeting? *

We encourage all early-stage researchers (Master, PhD students and Postdocs) to bring a poster to the Annual Meeting. You can either prepare a new poster or recycle one that you already have presented.

Yes

Other:

Do you also plan to apply for any/both of the following EpiEpiNet events?

If you plan to apply to any of the two following EpiEpiNet events please check the e-mails sent and register. For those participating in both the Annual Meeting and the Workshop in Rome, direct travel from Rome to Lisbon will be provided. To apply to the Workshop in Rome use the respective form sent through e-mail. To apply to the Workshop on Animal Behavioral Testing send an e-mail to epiepinet@gmail.com.

19-20 September 2022 (Rome) - Workshop - "Synaptic function in epilepsy disorders: from basic research to clinical implications"

26-28 September 2022 (Lisbon) - Technical Workshop - Animal Behavioral Testing: from handling to analysis

Will you require flight booking to attend the meeting? *

If you travel from outside Portugal, please select this option. If your participation is approved the flight costs and accommodation in Lisbon will be covered by EpiEpiNet funds.

Yes

A copy of your responses will be emailed to the address you provided.

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