REGISTRATION FORM FOR THE XVth ORTHODOX CONGRESS

FULL STAY

The form should be completed (using block capitals) with the information concerning you and all the people with you.

Please return to: Élisabeth Toutounov – 13 rue Guy Gotthelf – 91330 YERRES – France

Registration subject to availability of accommodation

Last name / First Name / Birth date / Languages spoken / Gender / Disabled Y/N / A
Adult
175 € / A’
Adult–Single room extra charge
95 € / B
Unemployed - Youngster15-25 yrs
100 € / C
Child
6-14 yrs.
75 € / D
Child
2-5 yrs.
45 € / E
Child
under 2 yrs.
0 €

Total…………………………………

Arrival hour on 30 April:………………….. - Family discount ……….. % …….

Means of transport:

Departure hour on 3 May:…………………...... Total to be paid:……………………

Means of transport:

Method of payment: - Bank transfer

-Cheque

-Credit card via PaypalName of account holder: ......

Bank account details: La Banque Postale - IBAN FR18 2004 1000 0122 6010 8V02 022 - BIC: PSSTFRPPPAR

Address…………………………………………………………………………………………………………………………………………………

Postal Code…..……………..…City…………………………….………….……………….. Country………………………………...…………..

Phone………………………… Mobile…………………………..E-mail………………………………………………………………………....

Registration is complete only after receipt of payment. You may however pay insix instalments (between February and July 2015).

REGISTRATION FORM FOR THE XVth ORTHODOX CONGRESS

PARTIAL STAY WITH ACCOMMODATION

The form should be completed (using block capitals) with the information concerning you and all the people with you.

Please return to: Élisabeth Toutounov – 13 rue Guy Gotthelf – 91330 YERRES – France

Registration subject to availability of accommodation

Last name / First name / Birth date / Languages spoken / Gender / Disabled Y/N / Rate category * / Thu 30 April / Friday 1 May / Saturday 2 May / Sunday 3 May / RATE**
Night / Dinner / Breakfastttt / Lunch / Dinner / Night / Breakfast / Lunch / Dinner / Night / Breakfast / Lunch

* Indicate rate categoryA, B, C, DorEas per price list.** See price list to calculate the total amount, according to number of nights and meals.

Arrival: Date: ……….. Hour: …………Total…………………………………

Means of transport:- Family discount ……….. % ……...

Departure: Date: ……….. Hour: ………….Total to be paid:…………………...

Means of transport:

Method of payment: - Bank transfer

- Cheque

-Credit card via PaypalName of account holder:………………………………..

Bank account details: La Banque Postale - IBAN FR18 2004 1000 0122 6010 8V02 022 - BIC: PSSTFRPPPAR

Address…………………………………………………………………………………………………………………………………………………

Postal code…..……………..…City…………………………….………….……………….. Country………………………………...…………..

Phone……………………… Mobile…………………………..E-mail…………………………………………………………………………….

Registration is complete only after receipt of payment. You may however pay insix instalments (between February and July 2015).

REGISTRATION FORM FOR THE XVth ORTHODOX CONGRESS

STAY WITHOUT ACCOMMODATION

The form should be completed (using block capitals) with the information concerning you and all the people with you.

Please return to: Élisabeth Toutounov – 13 rue Guy Gotthelf – 91330 YERRES – France

Last name / First name / Languages spoken / Price category * / Friday 1 May / Saturday 2 May / Sunday 3 May / RATE
**
Conferences / Breakfast / Lunch / Dinner / Conferences / Breakfast / Lunch / Dinner / Conferences / Breakfast / Lunch / Dinner

* Indicate rate categoryA, B, C, DorEas per price list.** See price list to calculate the total amount.

Arrival: Date: ……….. Hour: …………Total…………………………………

Means of transport:- Family discount ……….. % …….

Departure: Date: ……….. Hour: ………….Total to be paid:……………………

Means of transport:

Method of payment: - Bank transfer

- Cheque

-Credit card via PaypalName of account holder…………………………………

Bank account details: La Banque Postale - IBAN FR18 2004 1000 0122 6010 8V02 022 - BIC: PSSTFRPPPAR

Address………………………………………………………………………………………………………………………………………….....…

Postal Code…..……………..…City…………………………….………….……………….. Country………………………………...………....

Phone………………………… Mobile…………………………..E-mail………………………………………………………………………….

Registration is complete only after receipt of payment. You may however pay insix instalments (between February and July 2015).