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Registration Form

MEDIA 2020 CONFERENCE

5TH ANNUAL MEDIA2020 ASIA-PACIFIC – EUROPE MEDIA DIALOGUE

October 3, 2019, Bucharest

What unites us: Crossing borders in the digital world

Participant Details

Name & Surname (required)

Company name (required)

Position in Organization (required)

Office Address (required)

Office Country (required)

Telephone number (required)

Fax number (required)

Email Address (required)**

Accompanying person (required)

In case you need a Romanian Visa. Please fill in the following:

Full name as shown in the passport (required)

Nationality of birth (required)

Nationality on present (required)

Date of birth ( in YYYY-MM-DD format ) (required)

Passport Number (required)

Place of Issue (required)

Expiry Date ( in YYYY-MM-DD format ) (required)

City and Country where you will apply visa for Romania (required)

Travel Details

Arrival Date ( in YYYY-MM-DD format ) (required)

Flight No.

Arrival Time ( in HH:MM format )

From

Departure Date ( in YYYY-MM-DD format ) (required)

Flight No.

Departure Time ( in HH:MM format )

To (required)

Side activities: Excursion – 4th of October (required)
YesNo

Culinary preferences (required)
NoVegetarianOther

Your message here

* Please send this form by September 15th 2019

** If you do not receive an auto-reply confirmation email you either entered your email address wrong or something else went wrong !!!

*** SRR is a personal data operator, registered at NSAPDP***** with nr. 5772 / 2007

***** National Supervisory Authority for Personal Data Processing

All personal data collected by the Romanian Radio Broadcasting Corporation (SRR) are processed in compliance with the provisions of the Regulation (EU) 2016/679 concerning the protection of natural persons with regard to the processing of personal data and the free movement of such data (General Data Protection Regulation).

On the basis of Article 13 of Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016, we inform you that we will collect and process your personal data (name, email address, telephone number etc.) with the purpose of organizing the Media 2020 conference.

www.capsa.ro/booking.html In the “Message” section of the booking form please enter the code “RADIO”. The negotiated rate per night for a single room is 400 RON (approximately 85 euro) with all taxes included.

5th Asia-Pacific – Europe Media Dialogue

Register for Attendance