Please enable JavaScript in your browser to complete this form.University's Official Name (i.e. as it will appear on your CEEMC participation certificates)Team Member 1: Name *FirstLastEmail *Team Member 1: Contact Phone number *Team Member 1: Date of birth *Team Member 2: Name *FirstLastTeam Member 2: Email *Team Member 2: Contact Phone number *Team Member 2: Date of birth *Team Member 3: Name *FirstLastTeam Member 3: Email *Team Member 3: Contact Phone number *Team Member 3: Date of birth *Team Member 4 (if your team has 4 student members): NameFirstLastTeam Member 4: EmailTeam Member 4: Contact Phone numberTeam Member 4: Date of birthCoach 1: Name (if none, please just add a full stop (".")FirstLastCoach 1: EmailCoach 1: Phone numberCoach 2: Name (if none, please just add a full stop (".")FirstLastCoach 2: EmailCoach 2: Phone numberCoach 3: Name (if none, please just add a full stop (".")FirstLastCoach 3: Phone numberCoach 3: EmailDoes any team member or coach have special DIETARY requirements (e.g. additional night[s] accommodation and/or single room)? If yes, please specify which person and which requirements. If no, please leave blank.Does any team member or coach have special ACCOMMODATION requirements (e.g. requiring single-occupation room, or extra night[s] stay)? If yes, please specify which person and which requirements (and see the competition rules for additional fees which apply). If no, please leave blank.Any other requests or information you wish to provide (inc. info about your preferred accommodation arrangements)?Submit