Name*

Surname*

Organization/Institution* (Otherwise, you can put "own title")

Charge or Occupation*

Adress

Zip code

City

Country

Telephone*

Fax

Email*

Language*

Will you attend the morning session on February 4th ?

Si No

Will you attend the afternoon session on February 4th ?

Si No

Will you attend the morning session on February 5th ?

Si No

Will you taste the buffet offered by the organization on February 4th ?

Si No

Will you attend the cultural activity at night planned on wednesday the 4th ?

Si No

For any kind of special need, please let us know in the blank below

THE ATTENDANCE IS FREE. THE DEADLINE FOR REGISTRATION IS ON JANUARY 25TH. SEATS ARE LIMITED. PARTICIPANTS WILL BE ACCEPTED ON A FIRST SERVED BASIS.

LEGAL ADVICE — According to the Law 15/1999, december 13th, on data privacy law, we inform to the person concerned that all information sent will be managed into an IT systems which forsees the right to have access, to modify, and to delete such information, according to the law terms, through a document which has to be sent to the Secretaria Tècnica de la Jornada info@jornadausosdeltemps.net

I have read and therefore, I accept the data privacy clause*

* Compulsory fields.