Keynote Speaker Information Form – ICSP 2025

Please complete the form below with the necessary information for travel, accommodation, and conference logistics.

1. Full Legal Name (as it appears on your passport):
2. Date of Birth (YYYY-MM-DD):
    
3. Gender:
   Male
   Female
   Prefer not to say
   Other
4. Nationality:
5. Email Address:
6. Mobile Phone Number (with country code):
7. Passport or National ID Number:
8. Arrival Date in Lisbon:
9. Departure Date from Lisbon:
10. Arrival Flight Information:
11. Departure Flight Information:
12. Will you attend the Welcome Drink (3 December at 19:30)?
    Yes
    No
    Not sure yet
13. Conference Dinner (4 December – EUR 48):
    Yes
    No
    Not sure yet
14. Nazaré and Fátima Tour (7 December – EUR 87):
    Yes
    No
    Not sure yet
15. Hotel Room Type:
    Single
    Double (with companion)
    Twin (shared with another speaker)
16. Are you travelling with a companion?
    Yes
    No
17. If yes, please provide the full name of your companion:
18. Do you have any dietary restrictions or allergies?
    
19. Any special requirements (mobility, accessibility, etc.):
    
20. Additional comments: