Congress Afternoon Non-Member Ticket

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Congres Full Day Member TicketName *
Surname *
E-mail adress *
Vegetarian lunch will be provided, do you have any allergies/dietary restrictions?
Which speaker would be your first choice to attend at 2pm? (We cannot guarantee you will get this speaker) *
Which speaker would be your second choice to attend at 2pm? (We cannot guarantee you will get this speaker) *
Which speaker would be your first choice to attend at 3pm? (We cannot guarantee you will get this speaker) *
Which speaker would be your second choice to attend at 3pm? (We cannot guarantee you will get this speaker) *
Which speaker would be your first choice to attend at 4pm? (We cannot guarantee you will get this speaker) *
Which speaker would be your second choice to attend at 4pm? (We cannot guarantee you will get this speaker) *
Name of the accountholder paying for the ticket *
I am an international student
I allow Study Association of Psychology Labyrint to make and publish photos made during this event. In case I do not feel comfortable with it, I will send an e-mail to board@labyrintleiden.nl *

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Congress Afternoon Non-Member Ticket

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