Registration Form - Transform World South East Asia Poverty-Ideology
"Walk & Talk Conference" Surabaya, Indonesia : 14-17 September 2015
Full name please *
Name for your name tag *
Residential adddress *
Please include your city & country
Region *
Country represented *
Email address *
Contact no *
Please include your country and city/area code
Gender *
Age *
Nationality *
Passport no *
Passport expiry date *
Please note that your passport must be valid at least 6 months after 3 March 2016
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Will you need a visa to enter Indonesia? *
Please click here to check if you could apply visa on arrival: http://www.kemlu.go.id/singapore/Pages/AboutUs.aspx?IDP=55&l=en
Name of church/organization *
Position & responsibility in current church/organization *
Please give us brief explanation
Emergency contact person and number *
Please include country & city code
Sphere of influence *
Name & email address of person recommending you to join this summit *
Please choose your accommodation type *
Registration package based on single room occupancy (check in 14 Sep, check out 17 Sept)
The cost includes registration fee, accommodation based on single occupancy, airport transfer and meals during the conference
Registration package based on twin sharing (check in 14 Sep, check out 17 Sept)
The cost includes registration fee, accommodation based on twin sharing, airport transfer and meals during the conference
Scholarship information
Please contact twseapi.registrar@gmail.com for more details about scholarship.
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