European Parliament Interest Group on Mental Health, Well-being and Brain Disorders – 3rd December 2018 REGISTRATION FORM Title —Please choose an option—MrMrsMissMsDr First Name Last Name Function Organisation Your Email Do you have an access badge to the European Parliament? —Please choose an option—Yes, I have a badgeNo, I need a badge [group EPAccess] Nationality Date of Birth Place of Birth ID or Passport Number Type of Document —Please choose an option—IDPassport [/group]