SEEMF REGISTRATION FORM 2021

Registration deadline:9 October 2021

*
Mr Mrs
Name and surname: *
Media / Organisation / Company:
*
Position: *
Company Address (Street, City, Country): *
Private Address (Street, City, Country): *
Mobile phone: *
Phone: *
Public Email: *
Personal Email *
Date of birth: *
Place of birth: *
Special food / Remarks: *
I would like to become a SEEMO member: *
YES NO
I would like to receive newsletters from SEEMO / KAS / CEI: *
YES NO
My name and name of my organization / media / company may be included in the participant list: *
YES NO
My public email address may be included in the participant list:
*
YES NO
Please contact me for travel and accommodation details.
Additional information:
Please add your professional CV:

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Date / DD / MM YYYY
Signature:

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Please use the mouse (desktop computer) or the finger (touchscreen)
Please insert name, emergency phone number and email of person / persons who should be contacted in emergency case / accident:
Please note that with this form you agree that your personal data will be saved in the SEEMO database. Your personal information will be treated confidentially and it will neither be published nor passed on to third parties. Please read details about SEEMO privacy policy on https://seemo.org/privacy-policy/
Enter the letters you see in the image below (uppercase letters).