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Leadership from Within
Registration Form
First Name *
Your answer
Last Name *
Your answer
Organisation / Company
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Position / Title
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E-mail *
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Phone number (incl. country code) *
Your answer
Date of birth *
Nationality *
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Country of residence *
Your answer
Address - Street and number *
Your answer
Address - Postal Code *
Your answer
Address - Town / City *
Your answer
Skype ID
Your answer
How did you hear about this program? *
Food preferences (most food will be organic)
Additional information the organisers should know about me
Your answer
My registration has been submitted BEFORE Feb 23, 2017 *
I hereby register for this program and will attend as... *
I accept the costs for accommodation *
Confirmation / Cancellation Policy
Payments Policy
We will send you an e-mail with payment instructions. Please make sure your payment is received soon after your registration. Payments must be received before the March 3, 2017.

Travel arrangements
Should you be travelling from outside the Netherlands, we kindly ask you to check with us prior to making your travel arrangements. For help with your travel arrangements you can contact the organizers by sending an e-mail to OR call +31681462007

Cancellation Policy
When cancelled 4 weeks prior to the "Leadership from within" starting date, cancellation is free of charge. Between 4 to 2 weeks prior to the "Leadership from within" starting date, cancellation will be 50% of the costs.
Within 2 weeks prior to the "Leadership from within" program starting date, cancellation will be 100% of the costs.
We reserve the right to cancel the program (latest March 8, 2017) should the number of participants be too little.

We will confirm registration when the minimum number of participants has been reached.

I accept the Confirmation and Cancellation Policy *
Thank you for your registration and see you in The Netherlands!
Alexandra, Christiaan & Véronique
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