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Single delegate registration form LmunA 2023
Please fill in this form to register for LmunA 2023
The registration deadline is the June 11, 2023.
Please send an e-mail to
lmuna@lorentzlyceum.nl
if you have any questions.
* Indicates required question
Email
*
Record my email address with my response
Name
*
Your answer
Age
*
Your answer
Gender
*
Male
Female
Prefer not to say
Other:
Email
*
Your answer
Phone number (incl. country code)
*
Your answer
What country do you reside in?
*
Your answer
What is your address + postal code?
*
Your answer
What city do you live in?
Your answer
Request housing
*
Yes
No
LmunA maintains a strict refund policy regarding refunds. Cancellations after September 10th 2023, will result in a 80% refund. Cancellation after September 24th 2023 will be considered non-refundable.
*
I have read, agreed and understood the refund policy
LmunA also maintains certain conditions regarding the conference.
*
I have read, agreed and understood the Terms and Conditions
Additional information
Your answer
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