Registration Form

I am registering as the official representative of my organization.I am registering as a self pay participant.

Title

First Name

Last Name

Current position: Policy maker, student, grass roots, single activist, …
Policy makerLeadershipAnalyst / ResearcherActivist (student, grass roots, single activist)Other

We have arranged an exclusive pre-conference Shabbaton on Friday, Nov. 1st. If you would like to participate, please click below:

I plan to participate in the Training program by DEBATE professional facilitatorsI plan to attend the networking party

[Choose 3 out of the below choices!]
EU policy making / Working with parliamentarians / delegations on EU level / national levelRepresentative organizationsYoung leadership, youth and campusGrassroots activism – Mobilization; sharing of tools and resourcesWorking with social media / traditional mediaLegal Challenges & Issues – where legal fights make sense

One paragraph about yourself… (If available, please attach / submit by email some more personal background, a short CV and passport size photograph).

I am interested in setting up an info desk / exhibiting materials about my organization.
yesno

I agree that my data may be published in a participant brochure
incl. photoincl. address detailsincl. Email addressincl. 1 paragraph about myself

I understand that I am responsible for my own travel insurance. I relieve the organizers from all liability, which is not otherwise insured through the regular event insurance and insurance covered by the Concert venue / hotel

By checking this acceptance box I give my legitimate consent that I have read and agree to the European Israel Congress Privacy Policy.

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