EDERA FINAL WORKSHOP - Registration Form

EDERA Final Workshop 22 January 2025

Please fill this registration form providing details to help the local organisers with the required logistics for the meeting.

(*): Required field

(Please fill in the following fields, using the same data indicated in the ID Card / Passport to avoid problems with transports/accommodation)

First Name(*):

Last Name(*):

Citizenship (*):

Type of document (*):

Document number (*):

Date of birth (*): dd/mm/yyyy

Email address (*):

Confirm email address (*):

Phone number - including country code:

Name of the institution(*):

Country (*):

Position:

Address:

I consent to the recording of my image during the workshop. (optional)

I have read and accept the terms and conditions of UPC's Privacy Policy. (required)