Rotary Club Tbilisi International

ROTARY CLUB TBILISI INTERNATIONAL

ROTARACT CLUB TBILISI COSMOPOLITAN

Rotary International District 2450; GEORGIA

INTERNATIONAL SUMMER CONFERENCE

“World Supports Georgia – Active Citizenship Today”

24-28 July, 2011

28-31 July – Post Conference Trip

Registration Form

Name: Last Name: Sex:

Rotary/Rotaract Club: Other Organization/Club:

Tel: ( ) Mobile: ( )

E-mail: Address:

Country: City: RI District:

Position within Club: Interested in workshop:

Interested in Post Conference Trip Rotarian/Other (300€) Rotaractor (200€)

Date of arrival and flight #: Date of departure and flight #:

IF other means of transportation, please indicate –

Special requirements – vegetarian disable other:

Please mark:

Gold package: Rotarian (500€) Rotaractor (350€) Other: (500€)

This package includes – accommodation, transportation, program package, presents, all events and tickets.

Silver package: Rotarian (350€) Rotaractor (225€) Other: (350€)

This package includes –program package, transportation and events.

Bronze package: Rotarian (200€) Rotaractor (150€) Other: (250€)

This package includes –program package and Welcome Dinner.

1 Night Package: 125€ includes - Registration, Welcome Dinner, 1 night accommodation, participation within the workshop, lunch (day 2) and Main Conference attendance.

The Deadline for Registration is June 24th, 2011

Registration is possible through Rotary Club Tbilisi International web site