Registration

Contact details

We will use the details provided here to contact you regarding the course.

First Name *

First name as in passport.

Last Name *

Last name as in passport.

Given name

(if different from name in passport)

Gender

Male

Female

Date of birth *

Day

Month

Year

Nationality *

Email *

Mobile phone *

Organisation *

If you are an independent consultant, please type 'Independent Consultant'.

Type of organisation *

Job title *

Department

E-mail work *

Telephone work *

Address work *

Streetnumber

City *

ZIP / Postal code

Country *

Payment

Please note that we can only hold a place for you once we have received payment for the course.

Payment *

My own organisation is covering the course fees (please give name of contact person below)

I am applying for this course independently and will be paying the fees personally

Another organisation is covering the course fees (please give full details below)

I intent to contact potential sponsors in order to secure funding and will provide the details later

Organisation *

Contact person for payment *

Gender

Male

Female

Department

Address *

Streetnumber

City *

ZIP / Postal code

Country *

Email *

Telephone *

I am eligible for a 10% discount because I attended a MDF course within the past two years

I will be joining this course together with one of more colleagues of my organisation (Please get in touch with the MDF Training & Consultancy office offering this course to discuss organisational discounts)

Additional requirements

Do you require a visa to attend the training? *

Do you need accommodation near the training venue? *

If yes, please give your arrival and departure dates:

Arrival date

Day

Month

Year

Departure date

Day

Month

Year

Do you have any dietary needs? *

Do you have accessibility needs? *

Is there anything else we should know that may impact on your ability to fully participate in the course? *

Yes, I have read and agree with the [terms and conditions] for this course *

Yes, I have read and agree with the terms and conditions for this course

Leave this field blank