YMCA Europe General Assembly 2011

Personal information

Last name*

First name*

Date of Birth*

Sex*
MaleFemale

E-mail address*

Country*

Phone / mobile no.*

Mailing address for Working Documents

(if you do not fill the information bellow you will be able to download the Working Documents in electronical version only)

Address

Town

ZIP

Arrival/Departure

The trip from the airports to Den Dolder (place close to Sillem Hoeve) is not arranged. It is up to the participants to take a train to Den Dolder and they will be picked up there.

Arrival date (dd/mm)*

Arrival time (hh/mm)*

Arrival place

Departure date (dd/mm)*

Departure time (hh/mm)* (for travel arr.)

Accommodation

Type of accommodation* (Prices include: registration fee, programme, accommodation, meals, pre-arranged transportation to and from Den Dolder and excursion. Additional Fee: visa cost in your country.)
in Single Room (165 EUR per person per day)in Double Room (120 EUR per person per day)

Sharing with:

Additional nights

PLEASE NOTE: those rates apply only to 29, 30 and 31 (NGS pay the full rate). If you would like to arrive earlier or stay longer outside the dates 29.5.-5.6. you need to make arrangements directly with the Ernst Sillem Hoeve.

Exact dates of additional nights(in Single 85 EUR - example 2,3)

Exact dates of additional nights(in Double 72 EUR)

First Time at the GA
NoYes

Special food requirements(vegetarian, no pork etc.)

Choice of excursion*
Excursion 1. “Zaanse Schans”Excursion 2. “YMCA Challenge” by YMCA Works.Excursion 3. “Bike tour to YMCA Camp Leusden”Excursion 4. “Walking an extra mile ? “

Visa needed*
NoYes

Visa information - fill below ONLY if visa is needed

Passport number

Date of issue(dd/mm/yyyy)

Place of issue

Date of expiry(dd/mm/yyyy)

Nationality

Fax number

Mailing address

Home address

Antispam - 37: *

Items marked with an asterisk (*) are required