For those who want to attend the World Prayer Congress for Life 2010 in Rome, please register below. You will then be sent further information by email!

  *
Title
First Name *
Last Name *
 
Street / No. *
ZIP-Code *
City *
State/Country *
Date of Birth *
 (Format: DD.MM.YYYY)
Passport-No.
(required if travel by plane)
Citizenship *
 
Telephone *
 International Code           ( e.g. 001 for United States )
   Complete Number *     
 
E-Mail *
 
Native Language*        possibly 1st Foreign Language:                                                                            possibly 2nd Foreign Language: 

 
Congress: *
 I participate in the Congress::
 
  Full Congress: Tuesday 5.10. -  Sunday 10.10.2010
 I only can participate at the following days:  from      to      2010. 
        (If only one day, please choose the same date twice.)
                           Costs:          75 €    Congress Fee  (15 € per day)                          
 Accomondation *

I need Accomondation  from      to       2010
 Accomondation *          

Full Congress, 5 Nights:    DR / FB: 325.-- Euro     DR / HB: 275.-- Euro

I book *             Double-Room (DR)    Single-Room (SR)   (SR: +20.- € / Night)     

Board *             Half-Board (HB)         Full-Board (FB) (Standard)
Costs - Details see menu Lodging
I don't need Accomondation

 
Criteria for Assignment of Rooms in Hotel:
 
Organization affiliated with
 
I would like my Hotel room assignment in the same room with the following Congress participant as named below:     
Name


Place for Comments/Notices:
 
Important for the Organization of the Congress:
Workshop
If you want to participate in the PAS-Workshop, please select:

PAS-Workshop for Doctors and Persons im Counceling- und Healing-Service:
                                                     Sat. 9th of Oct., 3:00 - 6:30 p.m.
        
      Professional Category: *

                                        (if 'Other' please write here: )

Travel

I'm travelling with *


Your Date of Arrival* (Format: DD.MM.YYYY):     Time of Arrival* (approx.):   
 
                            For those travling by Train or Bus, please provide the following information:
                            Train-Station/Bus-Stop/City of Arrival: 
 
  For those travling by Airplane, please provide the following information:
  My Outward Flight Data:
 

Airport/ City of my Departure

  Airline Carrier
  Flight Number
Airport/ City of my Arrival
 
  My Departure Data back Home:
  Date of Departure
  Time of Departure
  Airline Carrier
  Flight Number

 

* Fields which must be filled out. 

 


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