EmailMe Form - PLAY conference registration

Given name(s)
(as held on passport) *

Family name
(as held on passport) *

Nationality *

Passport Expiry Date

DD / MM / YYYY

Date of Birth

DD / MM / YYYY

Mobile phone number
(Including international dial code) *

Email Address *

Do you require a visa for Spain? *

Yes I need to apply for one

Yes but I already have one

No

Name of Organisation *

Position in Organisation *

Web Site/Social Media *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Please describe your motivation to attend the event. *

Do you require a bursary to attend? *

Yes

No

The PLAY project has a limited amount of bursaries available.

What do you require the bursary for? *

Hotel/ Accommodation

Travel/ Flights

Both

Do you have special dietary requirements? *

Specific needs: Do you have any requirements because you are disabled, or needs related to religious requirements, or other needs?

On the evening of the 15th of October an informal gathering with drinks will be organised. Would you like to attend?

Yes

No

On the evening of the 16th of October a networking event will be organised for the participants. Would you like to attend?

Yes

No

Would you also like to attend the Catalan Congress on Sport and Cooperation that will take place the 17th-18th October? *

Yes

No

If yes, please register following the below links:

http://cooperaciocatalana.gencat.cat/en/que-fem/congres-esport-i-cooperacio-internacional/

http://cooperaciocatalana.gencat.cat/en/que-fem/congres-esport-i-cooperacio-internacional/inscripcions/

Please read the following statements and tick one. *

Yes, Fare network may use the information I have provided for future communication via post or email

No, Fare network may not use the information I have provided for future communication via post or email