European JCI Senators Summit 2019 - REGISTRATION
Given Name, Surname
Mobile Phone Number
Title Within Company
National Organization (JCI)
Local Organization (JCI)
JCI Senator no.
Are you bringing your partner/family?
If you are bringing your partner or family please specify the name, surname and age of the person(s) you bring with you.
Do you have any dietary requirements? If YES, please specify.
The cost for the whole period, including meals and transportation - excluding accomodation and transportation to/from airport
Early bird fee (31/12/18): 145€
Regular fee (21/03/19): 185€
Type and price of room - Hotel Timisoara (
Single room - 60 EUR/night (include breakfast)
Double room - 70 EUR/night (include breakfast)
How many nights?
The Role (Last or recent Role)
National Senate Board
Past ASE Board
Past National Board
Just a Senator
NOM Officer ( for the Romanians)
After registering the form you will receive an e-mail with all the necessary information to make the payment. If your company will support the cost of the business trip please specify the company and identification data.
Send me a copy of my responses.
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