Registration form - Beyond [15th - 19th Dec 2021]
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First name *
Last name *
Name that you want to be called in the training *
Please note that this will be the name appearing on your name tag.
Country *
Date of birth *
MM
/
DD
/
YYYY
Gender *
Phone number *
Email *
Please provide a valid e-mail address as it will be used for further communication with you.
Do you need a visa in order to travel to the Netherlands? *
Contact person in case of emergency *
Full name, address, phone number, relationship to you.
Diet *
Level of English *
Occupation status *
You can select more than one option.
In which Event Wise (Basic Synergy) Training did you participate and when? *
In case you participated or assisted in more trainings within the Synergy Group, please specify.
In which Choice Training did you participate and when? *
In case you participated or assisted in more trainings within the Synergy Group, please specify.
I am doing the Beyond (formerly known as Choice in Life) training for the following reasons: *
I declare that I will have a medical insurance valid in the Netherlands for the duration of the training. *
Required
Other remarks or questions
Communication and Data Agreements
We keep your personal data private. It will not be shared with a third party in any case.
If you have any question or need clarification, contact us at "info.oldevechte@gmail.com".
Data Processing Agreement *
Note: To make sure our emails get delivered to your Inbox, you must add our email "info.oldevechte@gmail.com" to your contacts list.
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