registration form

Name*

First name Last name

Pronouns

e.g. she/her, he/him, they/them

Contact details*

Email Telephone

Organisation*

Position*

Short biography (max 750 characters)*

Dietary wishes?*

(e.g. allergies)

Additional contact person (to be copied into email correspondence)

First name Last name

Email

Telephone

Which nights will you require accomodation?*

Please note that the conference will begin at 12:00 on Monday May 13 and end at 18:00 on Tuesday May 14.

Will you be joining the conference reception/dinner on Monday May 13?*

Do you require assistance with obtaining a visa?*

Additional requirements

Please inform us of any dietary, accessibility, child care or other requirements.

Phone

This field is for validation purposes and should be left unchanged.

contact us

info @ amsterdamdialogue.org