5GAA Conference Registration Form
Brussels, 6 February 2020

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* 1. First Name

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* 2. Last Name

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* 3. Company/Organization

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* 4. Position

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* 5. E-mail address (in case we need to contact you directly)

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* 6. Are you a 5GAA member or external participant?

Member of 5GAA

Industry Representative (non 5GAA member)

EU Institutions

Government Representative

Other (please specify)

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* 7. Do you give consent for 5GAA to distribute the conference list of participants during the meeting (including name & company/organisation name)?

Yes

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* 8. I would like to be updated regularly on 5GAA activities (approx. once a month; according to our GDPR regulations you can unsubscribe at any time by sending and email to secretariat@5gaa.org).

I agree

I prefer not to be updated.

Please be aware that the 5GAA Conference in Brussels will be photographed and filmed.

By attending this event, you give your consent to appear in any photo or video made by 5GAA. The images will exclusively serve 5GAA-related purposes and not any commercial gain. 5GAA is not responsible for any unauthorized use of the images.

Note:
In case you would not like to appear in any videos or on photos, please make yourselves known to the secretariat at secretariat@5gaa.org.

5GAA Conference Registration FormBrussels, 6 February 2020

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. Company/Organization

Question Title

* 4. Position

Question Title

* 5. E-mail address (in case we need to contact you directly)

Question Title

* 6. Are you a 5GAA member or external participant?

Question Title

* 7. Do you give consent for 5GAA to distribute the conference list of participants during the meeting (including name & company/organisation name)?

Question Title

* 8. I would like to be updated regularly on 5GAA activities (approx. once a month; according to our GDPR regulations you can unsubscribe at any time by sending and email to secretariat@5gaa.org).

5GAA Conference Registration Form
Brussels, 6 February 2020