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Launch of the European Year of Citizens 2013 & Citizens’ Dialogue 10 January 2013, Dublin Event Attendance Expression of Interest Form Name

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Address

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__________________________________________________________________________________ __________________________________________________________________________________ Date of Birth

_______ /_______ /_______

Occupation

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Organisation

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Email Address

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Contact Number

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In less than 200 words, please outline below why you would like to participate in the launch of the European Year of Citizens and the Citizens’ Dialogue event. Alternatively, you are invited to upload a 30 second clip to the CitizensDialogue2013 YouTube channel, stating who you are, what you do and why you would like to participate in this event.

For more information contact European Movement Ireland at citizensdialogue@europeanmovement.ie or call +353 (0)1 662 5815

Expression of Interest  

Expression of Interest

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