Raumanfrageformular Raumverwaltung - International Psychoanalytic University gGmbH - Berlin

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The fields marked with a ✔ are mandatory. All other fields are optional.

Angaben die hier nicht abgefragt werden oder weitere Informationen können unter 'Anmerkungen zur Belegung/zur Veranstaltung' weiter unten notiert werden.

1. Occupancy information

Occupancy information

1.1 Basic information

Number of persons

1.2 Period

Please select a room from the list above!

One-on-one appointment:

Beginning (TT. MM.YYYY)

End (TT. MM.YYYY)

... or 'individual appointments with different times':

1.Date (TT. MM.YYYY)

: - :

2.Date (TT. MM.YYYY)

: - :

3.Date (TT. MM.YYYY)

: - :

... or 'Individual appointments with the same times':

Time: : - :
Data can be changed manually or with the calendar icon with a ; can be added separately (TT. MM.YY;...)

2. Details of the contact

Details of the contact

If a customer number is known, enter it together with the corresponding e-mail address. Otherwise, optionally, only an e-mail address and other contact details.

Customer number

Salutation

First name

Last name

Company/Oranisation

Department

Cost center

Street, no.

Postcode

City

Country

web

Phone 1

Phone 2

Mobile

Fax

Date of birth

. .

3. Additional Information

Additional Information

Event title

Anmerkungen zur Belegung/zur Veranstaltung

Contact person (on site)

General remarks

4. Data privacy policy

Data privacy policy

Mandatory information

Yes, I have read the Data privacy policy and consent to the processing of my personal data! Link

Provider

International Psychoanalytic University gGmbH
Stromstr. 3b
10555 Berlin (DE)
Phone: 030 300117 801
sekretariat@ha.ipu-berlin.de

Betreiber (Plattform)

OMOC.interactive

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