European JCI Senators Summit 2019 - REGISTRATION
Email address *
Title
Given Name, Surname
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Birthdate
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E-mail Address
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Mobile Phone Number
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Occupation
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Title Within Company
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National Organization (JCI)
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Local Organization (JCI)
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JCI Senator no.
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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.
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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
Type and price of room - Hotel Timisoara (http://hoteltimisoara.ro/)
How many nights?
Check-in date
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Check-out date
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The Role (Last or recent Role)
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.
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