Bonaire Conference Registration form

Online registration form for Toastmasters International D81 Conference 2019

Note: Please submit one form per person. This form has Early Bird Registration prices
Early bird fee

Registration and payment receiv
Island tour BONUS

Registration and payment received before december 30, 2020 your island tour is free of charge and not transferable to another person.
Full Name*

First NameMiddle NameLast Name
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Email*
example@example.com
Firs time to attend D81 Conference?*

YesNo
Are you a toastmasters or a Guest?*

ToastmasterGuest
Toastmasters Designation

CCCLACBALBACSALSACGDTM
Pathways Designation

L1L2L3L4L5Mention your highest path
Club Officer
My Products
prevnext( X )
Full Conference$150.00

Payment date

Island tour$40.00

Contestant Full Conference package$60.00

Transportation$40.00

Total $0.00
District Officer
Are you a speech contestant?
Club number if speech contestant
Club Name*
Club Country*
A la carte option for Single ticket purchase

Educational Sessions May 16th $45Opening Ceremony May 16th $25Educational Sessions May 17th $35Speech Contest May 17th ( TT & Evaluation) $40Hall of Fame May 17th $40Educational Sessions May 18th $40International Speech Contest May 18th $ 40Installation & Celebration Eve May 18th $65
Total sum of A la carte tickets
Payment option*
Name on card
Card number
Exp date on card
YY-MM-DD
Bank transfer information:

Toastmasters International Conference

Account nr.41650102

Name Bank: Maduro & Curiel's Bank (Bonaire) N.V.

Swiftcode: MCBKBQBN
Arrival Date

MonthDayYear
Date
Arrival Time

:HourMinutesAM/PM Option
Departure date

MonthDayYear
Date
Departure time

:HourMinutesAM/PM Option
Carrier name
Flight number
Choose your hotel

Courtyard Marriott BonairePlaza Beach Resort BonaireOther
Assistance with your visa

You need to handle your visa application in case you need one

www.tourismbonaire.com/FAQ

Assistance to book your accomodation

Accomodation reservation needs to be handled directly with the venue of your choice. You may visit our official conference website for further assistance.www.caribbeantoastmasters.com/may-2019-conference
Emergency contact person(Name, phone and email address*
Should be Empty:

Online registration form for Toastmasters International D81 Conference 2019

Early bird fee

Island tour BONUS