Application form for the title of Lviv Honorary Ambassador 2021-2023

1
General information
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Educational and professional background
3
Association membership
4
Additional data

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General information

Name and surname *

Birthdate *

Phone *

E-mail *

Address of actual place of residence *

Foreign language knowledge *

Educational and professional background

Education *

Graduate, academic/doctoral degree(s), honorary title(s) *

Field of work *
ScienceEducationBusinessCulturePoliticsCivil societyITOther

Position and place of work/occupation *

Achievements, scientific works, publications, awards etc. that are recognized internationally *

Association membership and meetings' industry activity

Please provide a list of professional associations, member of which you are *

Please provide a list of conference events where you took part during 2018-2021 *

Please provide a list of conference events organized by during 2018-2021 *

Please provide a list of conference events that you plan to hold in/attract to Lviv during 2021-2026 *

Additional information about your participation in or organization of conference event *

Additional data

Please provide 2 personas that can give you recommendations to be honored for the title of Lviv Honorary Ambassador. *

Your high-quality portrait photo *

I give my consent to collecting, storing and processing my personal data * Yes

Application form for the title of Lviv Honorary Ambassador 2021-2023

General information

Educational and professional background

Association membership and meetings' industry activity

Additional data

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