Your details
First name*
Last name*
E-mail address*
Phone number*
Street and number*
Postal code*
City*
Country*
Date of birth (necessary for certificate)*
Highest education*
Profession*
Name of employer*
Costs & billing
I am:*
UvA Alumnus
UvA Employee
Not an UvA Alumnus nor an Employee (External)
E-mail for invoice
Invoice address
Reference number/ Cost center
If applicable, AUV (alumni) membership number
Other
How did you find out about this program?*
Other specifics (e.g. dietary requirements)
Terms and Conditions
UvA Academy Terms and Conditions
*
I acknowledge that I have read and understand the Conditions of Registration
I am aware of the administration costs in case of cancellation
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