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3rd Annual Open Space Day Registration Form
Thank you for your participation. Please complete the following questions and make the payment via the banking details provided below. We look forward to seeing you on the 29th of April!
Location of Open Space Day:
c2gether Offices
Bahnhofplatz 7
2502 Biel/Bienne
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Email
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Your email
What is your name?
*
Your answer
What is your occupation/title?
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Your answer
What is the location of your practice (e.g., Geneva, Zurich)?
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Your answer
What is the scope of your practice (e.g., adults, mood disorders)?
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Your answer
If you have a website for your practice, please feel free to share the link below.
Your answer
Would you like your information (name, contact information, photo and a short description of your practice) to be included on a registry of English-Speaking clinicians that we are creating?
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Yes, please include me on the registry
No, I prefer not to be included
I would like to learn more before I decide (we will email you)
Are you interested in presenting a workshop at the Open Space day on 29 April?
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Yes
No
Maybe
If you're interested in presenting a workshop, please provide a short description below, including the proposed length of the workshop (30 minutes, 45 minutes or 60 minutes).
Your answer
Did you participate in Open Space Day last year?
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Yes
No, this is my first time
Please confirm your registration by paying the 90 CHF registration fee via the following e-banking information: IBAN CH70 0079 0016 5997 2576 7 Elizabeth Ruth Frei
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I have paid the fee
The cost is a barrier to me joining this event (we will contact you)
How did you hear about the Open Space Day event?
Your answer
Thank you for your interest and registration! A confirmation will be sent to you shortly. Please feel free to leave us any other comments or questions.
Your answer
A copy of your responses will be emailed to the address you provided.
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