REGISTRATION FORM

Registration is open until 15th April 2023

► Registration after 15th April:

Due to organisational matters, any registration after this date will be confirmed individually, on a first come first served basis.

► If you are registering for another attendee:

Please fill in all the fields for this person by selecting the correct options so that the registration fee will apply correctly. Please also include the registrant’s email address for sending the registration confirmation.

Information about the participant:

First name:*

First name:

Last name/Surname:*

Last name:

Gender:*

Female

Male

Other

Institution:

Address for correspondence: *

Address:

Zip code:*

Zip code :

City:*

City:

Country:*

Country:

Billing Address (if different to correspondence address ):

Email address:*

All correspondence will be sent to this email address, including the automatic confirmation of registration.

Your email address for communication

Additional Email Address (if required):

Email Address

Phone:*

Your phone number for communication

Registrations fees:

Are you:*

*new members presenting at the meeting are considered as EDNSG members

EDNSG Member* (50€)

Invited Lecturer

EDNSG Observer/Non member (300€)

Accommodation:

► Members :

Accommodation is included in the registration price, on the basis of a shared room. For single occupation, please consider an extra charge of 129 €. For additional nights, please contact us: virginie.bougardier@univ-nantes.fr

► Non members :

Accommodation is not included. For any accommodation requirements, please contact us : virginie.bougardier@univ-nantes.fr

Would you like to book a room?

Yes, I'd like to book a room

No, I will book room by myself

Date of arrival:*

🗓 MAY 25

🗓 MAY 26

Date of departure:*

🗓 MAY 26

🗓 MAY 27

Please specify your choice:*

> > Happy to share twin bed room (no extra charge)

> > Member EDNSG single room (with extra charge 129 € for 2 nights)

Roommate, please specify your choice:*

I will accept organiser’s proposal

I have already a roommate

Please specify the fist name and the last name of roommate:*

Please specify the Name and Surname of roommate

Social programme:

Participation to the come together party:*

🗓 MAY 25,2023 🕤 8:30 PM – 10:30 PM

Yes

Are you on a special diet or have allergies?*

Yes

Please specify:*

Please specify your special diet or allergies

TOTAL AMOUNT TO BE PAID:

EDNSG Observer/Non member:

Please kindly note that the amount to pay indicated above doesn’t include room reservation.

We have taken note of your room reservation request. To book your room you are invited to contact us by mail: virginie.bougardier@univ-nantes.fr.

Terms and conditions - Personal data

Validity of the registration implies an acceptation of the General conditions and terms.

Cancel policy: Any cancellation prior to 26th APRIL 2023 included will lead to a full reimbursement. Any cancellation after this datewill lead to payment of the full amount of registration.

Information given through this form will be saved by AS connect évènement in order to register you to the event. They will be saved for 36 months. In conformity with the RGPD law, you can ask for a modification of the information by contacting : asaillard@asconnect-evenement.fr

Read our RGPD policy

I read the general terms and conditions and agree to them

I accept that AS connect évènement collects and uses the information given in this form in conformity with the RGPD law.

EDNSG NANTES 2023 – REGISTRATION

EDNSG NANTES 2023 REGISTRATION

TO REGISTER :

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