Delegate registration

Delegate Details:

Prof/Dr/Mr/Mrs/Ms etc

*First name

*Family name

*Job Title (in your organisation)

*Organisation

Department

*Address line 1

Address line 2 (if required)

Address line 3 (if required)

*City and post code

*Country

*Delegate's preferred language

*Telephone - country code

*Telephone - local code and number

*Delegate's email

This email address will be required for this delegate to gain access to our online workshop booking facility and should be unique to this delegate - please check it is entered correctly and keep a record of the address used.

*I accept that the European Social Network will retain the delegate's contact details in their database in order to send them information concerning the European Social Services Conference or other information concerning European social services. Following the conference, ESN will remove any details from its database on request. ESN WILL NOT SHARE THIS DATA WITH ANY THIRD PARTY

 YES
 NO

Delegate's Conference Attendance:

*I will attend the Official Reception
at 20h00 on Wednesday 2 July at the Hôtel de Ville, Paris

 YES
 NO

*I will attend the Gala Dinner
at 20h00 on Thursday 3 July

 YES
 NO

Please provide details of any special needs or restricted diet (please be as specific as possible)

If you wish to register a social companion for the Reception and Gala Dinner, please complete your registration process, then return to the main menu to complete a
SOCIAL COMPANION registration form (click here to view social companion fee details).

Invoicing details:

Please indicate here if the delegate is a member of an organisation eligible for a conference discount

(click here for details)

If you have claimed the ESN member discount, please name the ESN member organisation of which you are a member
(click here to see full ESN member list)

Please state any reference or purchase order number that you wish us to quote on your invoice

Please use this box to supply any further instructions or information relevant to your booking or invoice.

*Please tell us the email address to which we should send your invoice

(We will also send a copy of your current registration to this email address)

*Do you wish us to send a printed copy of the invoice by post?

 YES
 NO

If different from the delegate's details already provided, please supply the name and address of the recipient/organisation that you wish to appear on the invoice:

Organisation

For the attention of:

Address line 1

Address line 2 (if required)

Address line 3 (if required)

City and post code

Country

Please wait for the automated confirmation page to appear on your screen after you press the submit button - it contains information you may wish to read. A confirmation of the registration will also be sent by email to the address you have indicated above. Thank you.

Any problems or changes to your booking: please email louisa.greenbaum@esn-eu.org