CONFERENCE OF EUROPEAN CHURCHES
Therese Pache
P.O. Box 2100, 150 route de Ferney
CH-1211 Geneva 2, Switzerland
Telefax: +41 22 791 6227
E-mail: thp@cec-kek.org
women@imd.gr
Please complete and return until 15 March 2004
1. Name and Title:
..
..
2. Address:
.
3. Telephone (work/home):
...
4. Telefax (work/home):
5. E-mail (work/home):
6. I am:
__A member of CEC Central Committee
__A National Co-ordinator of the EFECW
7. Official position in Church/Agency:
8. Travel information:
__ AIR Arrival: Date: Hour: Flight:
Departure: Date: Hour: Flight:
__ RAIL Arrival: Date: Hour: Train:
Departure: Date: Hour: Train:
__ OTHER Arrival: Date: Hour:
Departure. Date: Hour:
9. Accommodation: Please reserve a room for me:
__Yes: __ Single Room (surplus 18.euro- per day) __ Double Room
__No
__Special diet:
.
10. Languages: English French Other
__Spoken:
.
.
.
__For documents:
.
.
.
(only one language)
11. Worship Services on Sunday:
Worship in parishes: Yes: No:
__ Preach:
__ Speak:
__ Attend:
__ Languages (indicate): English/French/German/Other:
12. Finances:
If you cannot cover your travel/accommodation expenses, either fully or in part, please indicate below the precise financial assistance you would require from CEC.
Please note that if you are asking financial assistance for your travel you must clear the procedure with CEC beforehand. You are kindly requested to choose the cheapest possible way of travelling. No tickets bought without express authority from CEC will be reimbursed.
Date:
Signature:
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