Eekhout Academy Erasmus+ final registration courses 2018-2019
Dear colleague

Thank you for your interest in our international courses! You can make your final registration by filling in this form.
Please fill in all requested information. The fields with an * are mandatory fields.

The courses will be confirmed when attended by a sufficient number of participants. We hope to be able to confirm the courses by the end of August.

You can fill in the registration form up to max 4 persons of your organisation.
If you want to register more persons, please fill in a second registration form after sending the first one.
PLEASE DO NOT FORGET TO SUBMIT AT THE END OF THE FORM !

Thanks!

Information applicant organisation
Name of the organisation *
Your answer
PIC of the organisation: *
Your answer
Official address organisation (street and number): *
Your answer
City and postal code: *
Your answer
Country: *
Your answer
Official website organisation: *
Your answer
Official email organisation: *
Your answer
Name of responsible (head of organisation): *
Your answer
Email of responsible: *
Your answer
Telephone number of responsible: (international country access code and number): *
Your answer
Only when different from the official address: Invoice address (street and number)
Your answer
Only when different from the official address: Invoice address (city and postal code)
Your answer
Personal information participants
Please fill in per person and per selected course. If the participant wants to apply for more courses, please fill in as a new participant.
Participant 1: First name
Your answer
Participant 1: Last name
Your answer
Participant 1: Gender
Participant 1: Email
Your answer
Participant 1: Mobile phone (international country access code and number):
Your answer
Choose the course participant 1 applies for
If participant 1 wants to apply for more courses, please fill in as new participant.
Participant 1: Costs of the course
We offer a flexible cost structure. This means you can choose out of three different packages: full package (€ 1250 in a single room/€ 1125 in a double room), lunch package (€ 855) and course package (€ 650). More information about the cost structure: www.erasmusplus-ist.eu/cost-structure. All nights during the course period are included in the full package (from Sunday evening until Friday morning). If you want to stay longer, please contact the hotel in order to book the additional nights.
Participant 1: Special requests (food, mobility, double rooms with ..., ) or questions ...
Your answer
To finish, please scroll down and submit this form. If not, proceed with the data of the next participant.
Participant 2: First name
Your answer
Participant 2: Last name
Your answer
Participant 2: Gender
Participant 2: Email
Your answer
Participant 2: Mobile phone (international country access code and number):
Your answer
Choose the course participant 2 applies for
If participant 2 wants to apply for more courses, please fill in as new participant.
Participant 2: Costs of the course
We offer a flexible cost structure. This means you can choose out of three different packages: full package (€ 1250 in a single room/€ 1125 in a double room), lunch package (€ 855) and course package (€ 650). More information about the cost structure: www.erasmusplus-ist.eu/cost-structure. All nights during the course period are included in the full package (from Sunday evening until Friday morning). If you want to stay longer, please contact the hotel in order to book the additional nights.
Participant 2: Special requests (food, mobility, double rooms with ..., ) or questions ...
Your answer
To finish, please scroll down and submit this form. If not, proceed with the data of the next participant.
Participant 3: First name
Your answer
Participant 3: Last name
Your answer
Participant 3: Gender
Participant 3: Email
Your answer
Participant 3: Mobile phone (international country access code and number):
Your answer
Choose the course participant 3 applies for
If participant 3 wants to apply for more courses, please fill in as new participant.
Participant 3: Costs of the course
We offer a flexible cost structure. This means you can choose out of three different packages: full package (€ 1250 in a single room/€ 1125 in a double room), lunch package (€ 855) and course package (€ 650). More information about the cost structure: www.erasmusplus-ist.eu/cost-structure. All nights during the course period are included in the full package (from Sunday evening until Friday morning). If you want to stay longer, please contact the hotel in order to book the additional nights.
Participant 3: Special requests (food, mobility, double rooms with ..., ) or questions ...
Your answer
To finish, please scroll down and submit this form. If not, proceed with the data of the next participant.
Participant 4: First name
Your answer
Participant 4: Last name
Your answer
Participant 4: Gender
Participant 4: Email
Your answer
Participant 4: Mobile phone (international country access code and number):
Your answer
Choose the course participant 4 applies for
If participant 3 wants to apply for more courses, please fill in as new participant.
Participant 4: Costs of the course
We offer a flexible cost structure. This means you can choose out of three different packages: full package (€ 1250 in a single room/€ 1125 in a double room), lunch package (€ 855) and course package (€ 650). More information about the cost structure: www.erasmusplus-ist.eu/cost-structure. All nights during the course period are included in the full package (from Sunday evening until Friday morning). If you want to stay longer, please contact the hotel in order to book the additional nights.
Participant 4: Special requests (food, mobility, double rooms with ..., ) or questions ...
Your answer
Please do not forget to submit. Thank you!
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