Center for Company Law

The fields with * are required.

I will attend both the oration and the conference
I only will attend the oration
I only will attend the conference
I will not attend the oration and conference, but by filling in this form, I would like to give the Center for Company Law my personal information, so I can be informed on future events.

Family name*

First name*                                        Prefixes
              

* Mr  MrsMs

Title(s)
Prof. Dr. Mr. Drs. MSc.
LL M Other:

I would like to receive mail at my: *

work address         private address        

Work address

Organisation

Department

Function

Postal address

City                                          Postal code         
   
Visiting address

E-mail address

Telephone                                                Fax
      
Name secretary

E-mail address secretary

Telephone secretary

URL of organisation

Private address

Street                                                    Number
  
 City                                               Postal code          
                   
E-mail address

Telephone                                                Mobile Phone   
      
Fax

Private URL

For those who will attend the conference, please indicate if you have dietary restrictions:

Remarks/questions

If you do not want to send this form electronically, please print it
out and fax it to us at +31-(0)13-466-2182