Andy_Jenner Tue, 14/05/2019 - 22:06 1 Start 2 Preview 3 Complete First Name * What is your first name? Last Name * What is your family name? E-Mail * Please leave us an E-Mail address through which we can contact you. Phone Number (including country-code) This will allow us to contact you should you get lost on the trip or arrive late to the meeting point. We will not use it ulterior. Are you an Erasmus-Student? * Yes No Are you in Augsburg with the Erasmus-program orthrough other means? Country of Origin * What country do you originally come from? ESN-Card Number Please insert the number that can be found on the front side of your ESN-Card towards the bottom. If you do not posses an ESN-Card, please leave this field empty. Is it possible for you to pay via bank wire transfer? * Yes No Further Notes: Is there anything else we need to know? Attention! This is a binding submission! * I am aware that this is a binding registration. By making this submission, I oblige myself to attend the trip and pay in cash on that day. Failure to pay will result in me being excluded from ESN activities for the remainder of the semester. I accept that my data will be forwarded! * I accept that the entered data will be stored until one month after the end of the event. The data will only be used for authentication within the ESN Germany organisation and its local section ESN Augsburg. Furthermore, ESN Augsburg is a local Erasmus initiative (LEI) which is partially funded by the German academic exchange service DAAD (Deutscher Akademischer Austauschdienst). For statistical and verifiable purposes I agree that following information will be passed to the DAAD: First Name, Last Name, Nationality, Erasmus status.