WRD24

REGISTRATION FORM

Please complete this registration form to reserve your spot at this special event.

I am

If Other, please specify:

First/Given name *

Last/Family/Second name *

E-mail address *

Study programme

Educational institution

I will be bringing guest(s)?

Yes

No

If Yes, please specify:

I am interested in volunteering for this event?

Yes

No

I require special accommodations:

Yes

No

If Yes, please specify:

I have food allergies:

Yes

No

If Yes, please specify:

I have dietary restrictions:

Yes

No

If Yes, please specify:

I heard about this event through

I would like to join the mailing list to receive updates on future events and initiatives:

Yes

No

Specific questions or topics I would like the speaker to address: