Evangelische Akademie Arnoldshain

Veranstaltungen / Anmeldung

Veranstaltungs-
archiv

Online-Registration for a Conference (german version)

Each person should register separately.

Blue marked Fields are mandatory.

I would like to register for the following conference:

VNr. 126144 12.07.2012 - 12.07.2012 Erinnern - Verstehen - Erzählen:

salutation:

title:

lastname:		firstname:
date of birth:	format: dd/mm/yyyy	nationality:

			address (job-related)

		institution/company:
		area of operations:
		title (work-related):
		job function:
		post office box:
	address (personal)	zip for post office box:
pstreet:		dstreet:
house number:		house number:
country:		country:
zip-code:		zip-code:
city:		city:
phone area code:		phone area code:
phone number:		phone number:
fax area code:		fax area code:
fax number:		fax number:
mobile number:		mobile number:
email:		E-Mail:

date of arrival and departure
date of arrival (format: dd/mm/yyyy)

date of departure (format: dd/mm/yyyy)

service
I wish the following food: regular dietary koscher vegetarian

further details: I'm a diabetic I'm allergic to: see notices

accommodation
a single room
a double bedroom together with Mr/Ms
a room for a handicapped person
I need the following help:

I prefer accommodation in a hotel in a single room a double bedroom
I do not need any accommodation

Additional infos by email
Please do not send me additional infos about your conference offers by email.

Notices

I accept the conference conditions and privacy terms.

Evangelische Akademie Arnoldshain
61389 Schmitten
Tel: +49 6084 9598-0
Fax: +49 6084 9598-138
E-Mail: office@evangelische-akademie.de