Application form Diversity in Research Design and Practice

Application form for the course Diversity in Research Design and Practice, June 26th

If you are an attendee of the PMRC conference and you would like to participate in the Diversity course, please fill out the form below. When you succesfully complete the course, you will receive a certificate. Therefore, we need some additional personal information. Please contact nig@uu.nl if you have any questions.
NOTE: The fee for this course is €100,-. After filling out this form, you will be automatically directed our payment webpage.

Name *

First

Last

Please state your full name (for certificate purposes only)

Email *

Phone *

University/ organization *

Date of Birth *

(For certificate purposes only)

Place of birth *

(For certificate purposes only)

County of birth *

(For certificate purposes only)

Are you attending lunch? *

There are no additional costs for lunch.

Please indicate any strict dietary requirements

Which pronouns do you prefer?

Optional

Would you like to receive our quarterly newsletter? *

Application is non-refundable *

I understand that my applicatoin to this course in under no circumstances refundable.