New application

Application
Fields marked with * are required
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Event Title/Course:
Organizer:
Starting date:
Ending date:
E-mail:
Course level:

Who is applying?

First name:	*	Enter your 'given name', example: John
Family name:	*	Enter your 'last name', example: Smith
Your AEGEE local:		Leave empty if you are not an AEGEE member - don't worry... :-)
Your studies:	*
End of studies (year):	*
Your date of birth:	*	Enter in the form of day.month.year (dd.mm.yy, example: 21.12.85)
Your sex:	*	female male
Care of:
Street:	*
ZIP/ postal code:
City:	*
Country code:	*
Phone:	*	+
Fax:		+
E-mail (no mistakes!):	*
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Visum required?		no yes
Passport no:
Nationality:
Place of birth:

Remarks (e.g. when will you arrive/ depart, what means of travel will you use etc.):
Should you require a visum provide any other information necessary:

I agree that the above data are electronically stored and processed for internal AEGEE purposes.

Click ONLY ONCE, not several times, and wait for the confirmation message.
If you provided an e-mail address, you will receive a copy of your entry in the specified mailbox.