FLL off-season aanmelding / registration
FLL off-season: Dinsdagmiddag 16 Mei 2017 vanaf 13:00 inloop, programma: 13:30 tot ca 18:00, tijdens de Dutch Technology Week, Night of the Nerds en de FTC Dutch Open in Eindhoven.

FLL off-season Tuesday afternoon May 16 2017 venue open from13:00, program 13:30 to 18:00, during the Dutch Technology Week, Night of the Nerds and the FTC Dutch Open in Eindhoven The Netherlands.

Ja, we willen meedoen met de FLL off-season in mei 2017 / Yes we would like to participate in the FLL off-season
Met welke regiofinale heb je meegedaan? / At which FLL regional did you participate?
Your answer
Teamnaam / Team name:
Your answer
Aantal teamleden / number of team members:
Your answer
Teamcoach naam /Team coach name:
Your answer
Teamcoach mailadres / Team coach mail address:
Your answer
Teamcoach telefoonnummer (graag mobielnummer) / Team coach phone (mobile number please):
Your answer
Tweede teamcoach naam / 2nd coach name:
Your answer
Tweede teamcoach mailadres / 2nd coach mail address:
Your answer
Factuur info / Billing information
Kosten voor een team (10 teamleden) bedragen €35,00. De factuur wordt toegestuurd.
Fees for a team (10 members) are €35,00. An invoice will be sent.
Adresregel 1 / Address line 1:
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Adresregel 2 / Address line 2:
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Stad / City:
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Land / Country:
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Inkoop nr of factuur referentie / Purchase Order number or reference:
Indien er een referentie of inkoop nummer op de factuur moet kunt u die hier aangeven / If you want us to mention a purchase order or reference on your invoice, please mention it here
Your answer
Leuk dat jullie erbij zijn! / Great having you in Eindhoven
Vragen, opmerkingen, ideeën? / Questions, remarks, ideas?
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