Registration form ECCEN 2020

Please fill in this registration form to join ECCEN 2020.

Personal information
Family name:
First name(s):
Gender:
Nationality:

Study/profession:
Organisation represented:
Mother tongue:
Special dietary requirements:

Adress of your organisation (for invoice)
Street and number:
City/Town:
Postal code:
Country:
Phone (include country code):
Mobile phone (include country code):

Emergency contact
Name:



Country:

Mobile phone (include country code):
E-mail:
Your relationship with this person:

Sleeping accomodation
You can stay at a hotel, or together with a hostfamily of the JSF school:	Please reserve a place in a hotel for 2 nights. Please reserve a place in a hostfamily for 2 nights Sleeping accommodation is not necessary.
I would like to share my room with:

Confirmation
Your e-mail address:
I agree to the terms and conditions:
I give permission for my name and contact information to be published in conference materials.:	In the materials distributed at the conference, we will publish the names and contact information for all participants, unless you specifically instruct us not to include your information.

Question or remark
Your questions or remarks: