"*" geeft vereiste velden aan

Name*

first name last name

Phone number*

Email adress*

Organisation

Preferred date

Please note: indicating a preferred date does not guarantee availability.

Preferred time*

17.00-18.30

20.00-21.30

Other:

If other, please specify:

Programme title*

Programme idea*

Have you already been in touch with SPUI25? If yes, with whom?

Any additional comments or questions?