Please send completed form to SKB International/E-mail: skb.international@skb.se
Information collected in this form and other documents connected to SGD will only be used for the Schools purpose  and follow SKB’s data protection policy, see further information: Personal data and data protection 
All personal data will be deleted, no later than one year after the school has ended.

Participant: 

	Family name
     

First name
     

Mr.				Mrs./Ms.			

Participant affiliation:

Company/Organization Name:
     
Company/Organization Address:
     
Postal Code:
     
E-mail:    
     
If invoice address differs from above, enter full invoice address:                          
                               

City:
     
Country:
     
Mobile nr.:
     

Participant information:
To be able to participate on the SKB International online training course all attendees must be able to register to SKB International Course Portal with your e-mail and mobile phone number. The login process demands a secure mobile application (app) available for all mobile OS. The app is called “One Touch” (see PhenixID.se for technical specifications)

I have a personal mobile phone and e-mail available for the login process for this course:

Yes	
No 		

My mobile unit is open for downloading a secure app for the login process:

Yes	
No 		

Attendees of the Online training course will receive a printed attendee list containing the following information; Name, E-mail address, Job Title, Organization, & Country. 
I reject the option to be listed on the attendee list:  

To optimise the course and to inform the lecturers of the audience we ask all participants to write a brief background summary; field of expertise, present work focus, managing or scientific position, affiliations main interests in the field of Geological disposal – consultant, scientific expert, managing national programme, etcetera. (This information will not be distributed outside the group of lecturers)

E.g. After working 10y with NNP Severe accident management I joined SKB International 2006. At SKB International I've been working within the national programme as project manager and analyst. Main focus.has been on operational safety analysis (SAR), radiological consequences, source term issues and spent fuel characterisation. Regarding long term safety I have been engaged in development of safety functions for the Low and Intermediate repository (SFR). International engagement has been in several countries including France, Belgium, UK, China, Japan etcetera. Including review of spent fuel conditioning facilities, strategy plans for underground research laboratories etcetera. My academical background is nuclear physics, thesis on Acceleration driven systems for transmutation of nuclear waste.