CONTACT DETAILS

* Title
MrMrsMs

* First name

* Last name

Job Title

* Phone number

* E-mail

ORGANISATION DETAILS

* Name of organisation

* Address

* Postcode

* City

* Phone number

* Country

* Type of Organisation (Select type of organisation)
Public bodyNon-profit organisationBusiness or professional associationResearch instituteAcademic sectorCivil societyOther (please specify)

Other...

EVENT DETAILS

* Name of event

* Dates of event

* Location of event and country

* Type of event
MeetingTraining programmeConference/seminarOther (please specify)

Other...

* Is this event co-financed by the European Commission ?
YesNo

Event address

(not to be completed if it is the same as the organisation’s address)

How and where will the event be publicised ?

* Has this event taken place before ?
YesNo

Expected number of participants

Nearest airport or railway station

* Type of audience

Press to attend ?
YesNo

Additional information to help us evaluate this request...

PRESENTATION DETAILS

* Title of presentation

* Date of presentation

* Length of presentation (estimated)

* Language(s) used

Language(s) used during conference and any useful information about interpretation facilities

* Subject area

(please select the correct subject area, as this will ensure that your form goes to the right unit, who will then be able to deal with your request promptly )

* Proposed content of presentation

* Total time allotted (in minutes)

* Q&A included
YesNo

* Indicate equipment available
LCD projector ;Computer with presentation software ;Other (please specify)

Other

Organisational details

Please attach any relevant organisational details (event agenda, speaker invitation, event programme etc.)

SPEAKERS DETAILS

* Role of the speaker (Select type of role)
SpeakerPanel ChairOther (please specify)

Other

Name of preferred speaker (if known)

Please consult OLAF's Organisation Chart