Attending PURE Lisbon, June 2024

Glad to hear you are attending PURE Lisbon
Please complete the balance of this form and click Submit.

Full Name - Enter your name as shown on your passport.
Title
Given Name 1*
Given Name 2
Surname 1*
Surname 2
Name Badge*
Gender*
Birth Date*

MonthDayYear
Study Position Title*
If you selected Other, please specify
Institution*
Centre #*
Country*
Passport Details
Country of Issue*
Passport #*
Date of Issue*
Date of Expiry*
Contact information
Home/Mobile Phone*
Business Phone
Extension
Your Email*
Travel Information
Transportation*
City of Departure*
Preferred Airline
Frequent Flyer#
Arrival Date*
Preferred Arrival Time
Departure Date*
Preferred Departure Time
Preferred Seating
Are you bringing a guest?*

YesNo
If Yes, provide the name of your guest
NOTE: Please contact meetings@heminggroup.com for details and costs.
Accommodations
Do you require Hotel Accomodation?*
Accomodation will be provided at Sheraton Cascais Resort for the 3 nights of June 23rd to 26th, 2024. (Extra nights are avilable at your own expense).
If YES, completion of dates below are REQUIRED.
Check in Date*
Check out Date*
Special Services
Are you attending the Welcome Dinner on June 23rd?*

YesNo
Special Dietary Needs
Additional Information
Should be Empty:

Glad to hear you are attending PURE Lisbon