Registration form

Name:


Address:


Place:


Country:


Telephone:


E-mail:
             



Accommodation:

€ 300/ € 370 room                                    €_____________


Bed and breakfast 27–28 April                €_____________+


Workshop price:                                         €_____________

Non “De Glind” sleeper (use of hall)       €_____________

Accommodation:                                        €_____________+


Total:                                                            €_____________



Vegetarian                                                   yes / no



Signature                                                      ______________


Bank account: Rabobank 3944.83.936

E van de Pol, Sterrelaan 45, 1217 PR Hilversum.

IBAN: NL37 RABO 0394483936

BIC: RABO NL2U