Mentortrain Kick Off Meeting . Malta - Registration Mentortrain Kick Off Meeting . Malta - Registration Name of Participant * E-mail of Participant Billing Details Details for Invoice * Details for Invoice Name of Institution Name of Institution Address Address City City State/Province State/Province Zip/Postal Zip/Postal Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Côte d'Ivoire Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country VAT Number for Invoice E-mail for invoice Special Instructions/Requests for the Invoice Accommodation All Accommodation is provided on a Bed and Breakfast basis in twin rooms at the Cavalieri Hotel in St. Julians. Arrival Day * Departure Day * Total Number of Nights at Hotel * Which guest are you? * Room is in My Name (€75 / night) I am sharing room with another participant (extra €5 / night) Which Guest are you staying with? * Alicia Leonor Sauli Miklavčič ANDRES MONREAL ALMANDOZ Anthony F. Camilleri Elsa Prédour Ion Artola Mendiola Iva Voldánová Jasmina Poličnik Marta Mugur MIhajela Crnko Oliver Kalda Ondřej Chrást ROSABENITO HABANS Sandra Feliciano Víctor Arias Rodríguez Sea-View Supplement I would like a sea-view (€10/night) Sub-Total Accommodation € Meeting Costs I am attending the following days of the meeting: Thursday 28th November (€40.00) Friday 29th November (€40.00) Meeting costs include venue rental, lunch and coffee breaks for each day of the meeting. Partner Dinner I am attending the partner Dinner (€50.00) Special meal requests Airport Transfers I would like a transfer from the airport to the hotel (€21.00) I would like a transfer from the hotel to the airport (€21.00) I will be joining someone else for the transfer All airport transfers are done by taxi, and take c. 25 minutes. Shared transfers are available at the airport for a cost of €9, and take c. 1.5-2 hours to reach hotel. We will contact you 1 week before the event to confirm your flight details for pick up. Who are you joining for the transfer? * Alicia Leonor Sauli Miklavčič ANDRES MONREAL ALMANDOZ Anthony F. Camilleri Elsa Prédour Ion Artola Mendiola Iva Voldánová Jasmina Poličnik Marta Mugur MIhajela Crnko Oliver Kalda Ondřej Chrást ROSABENITO HABANS Sandra Feliciano Víctor Arias Rodríguez Sub-Total Meeting Costs € Payment Grand Sub-Total € Agency Fee € Tax € Grand Total € Pay by * Paypal / Credit Card Bank Transfer If you are human, leave this field blank. Submit