Registration Table Top - Next Step Master Day

Your name*

Your email address*

Name institute*

How many tables do you need?*

Full name Master Programme 1.1*

Name contact person 1.1*

Email address 1.1*

Is there another master programme for the same table? 1.2*

Full name Master Programme 1.2*

Name contact person 1.2*

Email address 1.2*

Data table top 2

Full name Master Programme - 2.1*

Name contact person - 2.1*

Email address - 2.1*

Is there another master programme for the same table? - 2.2*

Full name Master Programme - 2.2*

Name contact person 2.2*

Email address - 2.2*

Do you need table covers?*

We can provide them for you (free of costs) or you can bring your own.

For how many tables do you need a table cover?*

Please specify for how many tables you'll need a table cover.

Additional C2W | Mens & Molecule exposure package

Do you want the additional C2W | Mens en Molecule exposure package?*

For which master programme(s) do you want the package*

(prices are per master programme, not per institute)

Invoice data

Data needed to prepare an accurate invoice for you*

Such as unique invoice number (Budget/SAP-number), adress, e-mail adress, etc.

Additional information

e.g. Purchase order

I agree to the cost of €175 per registered table + any charges for the additional exposure package.*

If you have any questions, please do not hesistate to contact Elbrig Jansma (ejansma@kncv.nl).