Request edit access
Registrationform A-Tri part 6
Date: 2018, February 23-25
Location: Vondelchurch Vondelstraat 120 Amsterdam
First name *
Your answer
Surname *
Your answer
Country of residence *
Required
E-mail *
Your answer
Tarifs
€ 160,- (living in the Netherlands)
€ 110,- (not living in the Netherlands)
I will pay *
Remarks (info: seminar@ligmincha.nl)
Your answer
Payment details
Payments are to be made before 2018 February 15th to account number of Ligmincha Nederland, Oisterwijk.
Please include <name(s) of participant(s)> and <A Tri 2018>

IBAN NL56 INGB 0006 2885 89
BIC INGBNL2A

Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms