EUROPIANO 2012

Select another language

Questionnaire

Male / Female	Male Female
Last name	(*)
Initials	(*)
First name
State or county	(*)
Zip code	(*)
Country	(*)
Other
Preferred language	(*)
Telephone	(*)
Mobile
Email address	(*)
website address

Main professional skills
focusses on
Preferred topic lecture or workshop at Europiano 2012
Has given lectures before - experienced reader	Yes No
Has visited a Europiano Congress before	Yes No
If so, when?
Do you intend to derive any commercial profit by attending Europiano 2012	Yes No
Do you intend to display any products?	Yes No
Would you like to sponsor this Congress in any way ?	Yes No
Remarks or suggestions

All the given information will only be seen by the Europiano 2012 organisation. No rights can be deducted from the given information.
I accept these conditions	Yes