Lead prevention campaign - Event registration
Fields marked with an asterisk (*) are mandatory.

Event registration
Organization name *
Type of organization  *
If Other, please specify
City/Area: *
Country: *
What type of activity do you plan to organize for ILPPW?  *

To make multiple selections, press the "Ctrl key" and click on the items to choose.
Click to Select / unselect all
If Other, please specify
Title of event: *
Brief description of event: *
(max. 100 words)
Target audience for event:
(max. 100 words)
Start date: *
 
The date format is "dd/mm/yyyy"
End date: *
 
The date format is "dd/mm/yyyy"
Related web site:

The URL format is "http://xxxxx". Test the URL
Which of the ILPPW materials provided by WHO and UN Environment do you expect to use this year? *

To make multiple selections, press the "Ctrl key" and click on the items to choose.
Click to Select / unselect all
What results do you expect from your ILPPW activities? *

To make multiple selections, press the "Ctrl key" and click on the items to choose.
Click to Select / unselect all
If Other, please specify

Contact for more information
Name:
E-mail: *

The e-mail format is "xxxx@yyyy.zzz"
Leave this question empty if you are human: