Middle East & Caucasus Tour Registration #

Organization/Company name: *

Country: *

Industry/Activity: *

Location: *

Email: *

Phone: *

Address: *

Website:

Name of the responsible/contact person: *

First

Middle

Last

Direct Email: *

Direct email of the responsible/contact person.

Direct contact: *

phone, cell phone, Skype, etc.

For which program(s) would you like to register? *

Other program?

Would you like to use the coaching and counseling support after the program? *

Optional support according to multi-layer support in CES format

When is your preferred date to start the requested program? *

The final date will be determined by future coordination.

Estimated number of attendees in one/each program? *

What is your preferred format for attending in empowering programs? *

Preferred location for the program: *

Full address of the place where you want the program(s) will be provided.

This form is being sent in order to: *

Do you want to use 15% extra discount? *

Yes. I will pay the total program fee and finalize my registration before 31 August. (Full payment)
No. I want to pay the 20% prepayment now and pay the remaining fee in place. (when the program finishes)

Other descriptions:

Optional

I have studied, understood and accepted all the programs descriptions, terms and conditions, payment conditions and other considerations. *