Annual MPNE workshop for MPNEhubs
24-26th November 2017
Krusenberg Herrgård

Application for the Annual MPNE workshop

Workshop participation upon application only, please do not book your travel before you have been accepted.

DEADLINE FOR APPLICATION
14TH OCTOBER 2017

* 1. Your contact information

* 2. Your relationship to Melanoma

  Stage 1 Stage 2 Stage 3 Stage 4 currently NED (no evidence of disease) n/a
I am a Melanoma patient
I am the carer of a Melanoma patient whose disease is in
Other

* 3. Your/ the patient's Melanoma is

* 4. What is your profession?

* 5. Are you working with a Melanoma advocacy group?

* 6. How much Melanoma Advocacy experience do you have?

* 7. The Workshop is in English - what is your level of English?

* 8. One of the aims of this workshop is to connect European Melanoma advocates. Are you happy to share your email address with the other participants of the workshop?

* 9. Your proposition of the Melanoma advocacy project YOU want to run with the help of our network

* 10. Is there anything else you would like us to know ?

* 11. I have read and accept the Participants Agreement.

PARTICIPANT'S AGREEMENT

Participation in the Krusenberg 2017 workshop

24th- 26th November 2017, Krusenberg Herrgård , Sweden


Financial Support
MPNE  agrees to cover registration, full-board accommodation for 3 nights and travel expenses up to a maximum of 400 Euro for participants selected to attend the Workshop. It is the responsibility of the participants to declare the grant provided by MPNE to their financial institution if applicable.

Please note we will inform you if your application has been successful within 3 working days after the deadline, and you will then receive further logistical information. Please do not book travel/flights until you have been informed of your successful registration.

Travel 
MPNE will provide travel grants to participants, up to a maximum of 400 euro (this amount includes all travel expenses - train, flight, car- for economy/ 2nd class travel). Participants will be responsible for booking their own travel and they will be reimbursed after attending the full conference on completion of the reimbursement form together with travel receipts. Please note that participants are responsible to arrange their own travel and airport transfers! We will however share forms on Slack to share taxis from the airport to arrive at Krusenberg.

Accommodation
MPNE will book accommodation for you at the conference venue for 2 nights (Friday and Saturday). Accommodation will be full-board, in single rooms. Participants will be liable for all extra costs. Should participants desire to stay extra nights, these need to be directly arranged at the hotel and covered by participants themselves.

Filming/ photos
By accepting their place at the Access to Innovation Workshop 2017, participants agree to being filmed/ photographed at the conference and those images to be used for MPNE work, like the conference documentation. We will not prominently use single photos of you without asking but that just becomes impossible for group pictures!

Insurance
MPNE bears no responsibility for untoward events in connection with, before, during and after the conference. Participants are advised to take out their own personal and travel insurance coverage.

Attendance and Preparation
By accepting the Participant's Agreement, participants declare that they will attend the full workshop in Krusenberg. This workshop will produce a concrete projects for the entire MPNE network to the benefit of Melanoma patients. Preparation and participation are therefore crucial. Participants agree to prepare appropriately for the workshop.

WE LOOK FORWARD TO SEEING YOU IN KRUSENBERG!
Bettina, Gilly and Violeta

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