This document is a pre-registration form for a seminar on developing European dialogue on culture and education taking place in Brussels from June 24-28, 2013. It requests the participant's contact information and for them to select either an accommodation package organized by the Belgian-Italian Chamber of Commerce for €600 or to independently arrange their own stay in Brussels for the period of the course, with the full course fee being €700. Participants are asked to return the completed form by email before January 14, 2013.