Form cover
Page 1 of 2

SafierrReef26 Registration

Registration

First name

Last name

Gender

Gender
A
B

Date of birth

Nationality

Title

Title
A
B
C
D
E

Personal photo

For badges / internal use.

Email

Mobile phone

With country code, e.g. +49…

Country of residence

City

WhatsApp number / Telegram

If different and relevant for communication.

Current affiliation type

Current affiliation type
A
B
C
D
E
F
G

Name of institution / organisation

English.

Name of institution / organisation

Arabic, if applicable.

Department / Unit

Position / Role

For example: Assistant Professor, PhD student, Director, Farmer representative, Project Manager.

Are you submitting a contribution?

Are you submitting a contribution?
A
B
C

Do you require a participation certificate?

Do you require a participation certificate?
A
B

Dietary requirements for catering

Dietary requirements for catering

Consent for data processing

I agree that my data may be stored and used for the organisation of SAFIERR events and related communication.
Consent for data processing
A
B

Consent for inclusion in participants list shared with other attendees

Name, institution, email.
Consent for inclusion in participants list shared with other attendees
A
B

Consent for photo / video use

I agree that photos and videos of the event in which I may appear can be used for documentation and communication of SAFIERR (website, reports, social media).
Consent for photo / video use
A
B

Permission to receive future SAFIERR news and calls

Permission to receive future SAFIERR news and calls
A
B

Have you previously attended a SAFIERR event?

Have you previously attended a SAFIERR event?
A
B

What do you hope to gain from this event?

Open text, 2–3 sentences.

Are you interested in:

Are you interested in: