Futures Thinking

Personal details

First name *

Full name *

Middle name/affix

Last name *

Date of birth *

dd-mm-jjjj

E-mail address *

Mobile phone number *

ICE phone number (in case of emergency)

Hometown *

Give a short introduction to your previous experience in this area, both in study and work *

What is your motivation to join this programme and what are your personal learning goals for this course? *

Have you already followed a course at our organisation? *

No

Yes, namely: Yes, namely:

Work

Organisation *

Department *

Function *

Location *

Practical information

In case you have any questions, please fill in your question or contact Alicia Slooff directly via mail (b.a.slooff@ha.leidenuniv.nl)

Participating the Honours Master Class Futures Thinking costs 1500 euros. Later on you will receive a payment link to finalize your registration.

Thank you for filling in this form!

* = Invoer verplicht