Registration form Hydrogen Academy Brussels

Hydrogen Academy Belgium
Registration form

First name

Last name

Company/Organisation

Street + number

Postal Code

City

Function title

Email address

Mobile number

Cost

is participant and pays €900, - (excl. VAT)

is member of the Waterstof Industrie Cluster and pays €300, - (excl. VAT)

is younger than 18/Student and pays €300, - (excl. VAT)

is an employee at a government agency and pays €300is werknemer bij een overheidsinstelling en betaalt 300,- (excl BTW)

Email address for invoicing (if different from the email address above)

VAT number

If you do not have a VAT number, please enter N/A

PO number

If you do not require a PO number, please enter N/A

Dietary requirements

Remarks?