Louropa Forum application form

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Application form Louropa Forum 2011

STUDENT INFORMAT ION

Name

Nationality

Current CEMSschool (as of Spring 2011)

Home CEMS School

Master’s degree

Telephone

(   )

E-mail

E-mail (additional)

Your official MIM year

09/10

10/11

11/12

ACCOMODATION (PLEASE TICK THE RELEVANT BOX) Accommodation needed

Accommodation not needed on campus

COMMENTS AND QUESTIONS       Do you have any allergies we should be aware of?

Dietary wishes or requirements? (pleasetick if relevant)       Other comments?

When you sign this form that the application is binding and that it is mandatory to attend all the skill seminars during the event Signature (type your full name and sign)

Location & Date

Pleasenote that participation in the CEMSLouropa Forum 2011 is subject to a participation fee. Pleasesubmit this application form, together with your CV to louropa2011@gmail.com at latest by Friday 15 th April 2011, 7 pm (GMT+1). Incomplete applications will not be accepted. Note that selection will be based on a first come first serve principle and applications will be accepted from the 13 th April 8 am (GMT+1). Students should fill in the registration form, print it, sign it, scan it, and send it by email to louropa2011@gmail.com, together with their CV . For further questions please contact Louropa Forum Coordinator at louropa2011@gmail.com


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