REGISTRATION FORM

Deadline to submit your registration: Friday 02nd June 2017

DISCLAIMER

Photography and video recording may be taking place at this event and these images and footage might be used on websites, social media platforms and publications for promotional purposes. By filling this form you are allowing the organization to use any photograph or video taken during the event. Data are collected for the specific objective of the event itself and its follow up, according to the Regulation (EC) No 45/2001.


PERSONAL DETAILS

Please fill in your personal details exactly as they appear in your passport.

Title :*

 
First name :*
 
Family name :*
 
Organisation :*
 
Job title :*
 
Type of organisation :*

 
Nationality :*
 
Country of residence :*

 
Telephone :
E-mail :*

We would like to facilitate networking among participants.

May we share your email through the delegates list, to be distributed on the day of the event?

 

What is the first word that comes to your mind when you think of crowdfunding for culture (apart from crowd and funding)? *

 

What is the main reason you are interested in this conference? (Please state in ONE word, i.e. fun, interest, learning, networking etc. Be creative, don’t copy only the suggestions) *

 

TRAVEL AND ACCOMMODATION ARRANGEMENTS

Due to budgetary constrains, the European Commission can only cover travel and accommodation costs on special cases.

Do you require financial assistance to arrange your travel and accommodation in Brussels?*
 

WORKSHOPS

You may be able to attend one of the workshops that will take place during the conference. Please note that places are limited and will be allocated on a first-come-first served basis. Please indicate your first and second preferences from the list below and we will try to accommodate your wishes.

1ST PREFERENCE

 
2ND PREFERENCE

 

CATERING

Please be aware that your participation will be counted for the provision of food during the event. In order to contribute to the reduction of food waste, we kindly ask you to contact us as soon as possible should you not be able to finally attend the conference.

Please specify special needs you have :



Other, please specify :

CONTRIBUTIONS

We would like to engage with participants on social media.

We would also like to hear from you and your ideas. If you would like to take an active part in the conference, please let us know!


SPECIAL ARRANGEMENT

Please provide details and indicate the nature of the special arrangements that would be necessary :*

For enquiries about the event and should you have any problems filling in the questionnaire, please contact:

Cristina Martínez
T: +32 (0)2 7438568
M: cristina.martinez@ecorys.com

For enquiries about the project, please contact info@crowdfunding4culture.eu

Stay tuned for updates on Twitter, Facebook and our Website. For more information please contact us at info@crowdfunding4culture.eu.