Conference 2009 | Registration form

Superprojects

Registration form

General information about you
Club*	Date
Last name*	First name*
Position	Nickname
Country	City*
Phone	E-mail*
Fields market with * are required
I want to participate in the District 5010 Assembly and Conference (11.06.09-13.06.09)
I am a Rotarian	I am a Rotaractor / an Exchange student

Events you planned to visitCost
I want to participate in the ICC meeting (14.06.09-15.06.09).
I want to participate in the "Independence Day" party (12.06.09)
I want to participate in the "Paul Harris Society Fellows" breakfast (13.06.09)
I want to participate in "Governor's banquet" (13.06.09).
I want to participate in the Novosibirsk city tour (11.06.09).
I want to participate in the entertaining program at the ICC (14.06.09)

Residence time in Novosibirsk	Accomodation
Date of arrival (DD/MM)	Variant of accommodation See "Accommodation" sheet
Date of departure (DD/MM)	Cost of accommodation$0
A number of days	I need transfer
You have chosen a double room. Please, give us the name of your spouse. A separate form for a spouse is required:
You have chosen a berth in a double room. Please, give us the name of your supposed neighbour:
I need a diet:
Total

You can also download Registration form. Microsoft Excel, size 39Kb After filling please send form to [email protected]