Registration form: OOA retreat 2019 Deadline for registration AND abstract submission is August 25. Check www.ooa-graduateschool.org/retreat-2019 for details how to submit your abstract. PLEASE NOTE: Last year we didn’t have enough places available for all interested PhD students. It has therefore been decided that all students that went to the OOA retreat last year for the first time, cannot participate this year, but they can join the OOA retreat again in 2020. Only when you will complete your PhD trajectory before October 2020, you can participate this year. 1 Personal Data2 PhD project3 Personal dataName* Surname Prefix First name Gender*FemaleMaleGNEmail address* Cell Phone number*Department*Institute*Amsterdam UMC, location AMC/UvAAmsterdam UMC, location VUmcNKIAvLProject number or 'kostenplaatsnummer'*Email address financial department*The retreat fee (€350,-) for AMC/UvA PhD students will be paid by project fundings that are managed by the supervising PI. By providing a 'kostenplaats' or project number that can be used for payment and email address of the financial department to which the invoice can be sent, you declare that your supervisor (PI) approves your participation in the OOA retreat and the related fee. PhD projectStart PhD project*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Function*AIOSANIOSOIOMDMD/PhD studentPostdocSpecialist onderzoekerOtherGroup/project leader*Project title* Information retreatPresents a*Poster (only in first 1.5 years of PhD project)PresentationTakes bus on wednesday*NKI/AvL busAmsterdam ZuidOwn car (travel costs will not be reimbursed)Takes bus back to Amsterdam on Friday*NKI/AvL busAmsterdam ZuidOwn car (travel costs will not be reimbursed)Preference room mateSpecial requests regarding meals (all meals will be with a buffet)*NoneVegetarian (no meat)Vegetarian (no meat, no fish)VeganNo pork/halalOtherDo you prefer a printed or digital (PDF) abstract book?*PrintedDigitalNo preferenceRemarksHow may times did you join the retreat already?*NeverOne timeTwo timesThree timesYear*Have you been a chair on the retreat?*YesNoPlease noteIf you don’t receive a confirmation mail, your registration failed. In that case, please try again or contact us (email@example.com)! EmailThis field is for validation purposes and should be left unchanged.