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Registration Form AI&II Annual PhD retreat 2020
Location: Hotel van der Valk, Volendam
Date 2 & 3 April, 2020
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* Indicates required question
Your name
*
Your answer
Your email address
*
Your answer
The department you work in
*
Your answer
In which AI&II program(s) are your registered?
*
Inflammatory Diseases
Infectious Diseases
Cancer Immunology
Required
Location
*
AMC
VUmc
Sanuin
GGD
Reade
other
Required
PhD year
*
1st
2nd
3rd
4th
Required
Abstract title
*
Your answer
Abstract text (max. 250 words)
*
Your answer
Diner preference (please mark only one option)
*
Meat
Fish
Vegan
Required
Food allergies
Your answer
Overnight stay at the van der Valk hotel
Yes
No
With whom would you like to share the room with?
Your answer
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