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Registration form innerSouls Event – April 14 2019

This form is HTTPS/SSL secured. So you can send your data safely to us.

INFORMATION: Why is it necessary to hand in a well-filled registration form? (Dutch explanation)
Before you start filling out the form, first read the House Rules.

* Completing is necessary

* I subscribe to the 'innerSouls Event' of April 14 2019
YES

* II have read and agree to the House Rules
YES

* Name

* Surname

Company name

Chamber of Commerce number

* IBAN number

* E-mail adress

Website

Facebook

* Adress (street + number)

* Zipcode

* Place of residence

* Country

* Home and/or mobile phone

Your place of choice and payment

* I would like ... table(s)/open space(es)
After your choice you will see the final amount
- Size table: 110 x 90 centimeter
- Size of open space: approximately 2,50 x 2 metres
There are enough chairs available.
* Click in the field below and choose.

* I pay my TOTAL participation fee before February 28.
I will prepare a transfer so that I do not have to be reminded of this payment.

YES
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ATTENTION: The account number has been changed since December 2018!
Account number: NL73 RBRB 0706 6645 74
In the name of: innerTeacher (J. Laforce)
Quoting: innerSouls Event April 14 2019 + your full name and company name.
Your placement may only be granted if your payment has been credited to the above account.
After having paid your total participation amount, you will receive the VAT invoice via your E-mail.

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* What is my activity at the Event
* Consult
YESNO

* Sales
YESNO

* I would like to give a lecture/workshop.
Attention:
if you select to give a lecture/workshop, it does not mean that you will be classified for it.
Hoping for your understanding.

YESNO

What will this lecture/workshop be about?

I make a contribution to the FREE lottery (a product, a session, a treatment or something else available).
EXPLANATION: What does that mean, a contribution to the lottery? Click here. (Dutch explanation)
* My contribution is

* Is my donation for the Event or at another place/moment?
For the EventFor another place/moment

* I would like to participate in SpeedReadings. _ What is SpeedReaden? Click here. (Dutch explanation)
YESNO

* I would like to join the POWERhealing as a healer.
What does that mean "participate with the POWERhealing"? Click here. (Dutch explanation)

YESNO

* I authorize the making and publishing of photos and / or film during the Event by our innerSouls photographer.
An answer is needed i.v. the privacy law from May 25th 2018!

YESNO

* I want to receive FREE ENTRANCE admission tickets to distribute to (un)acquaintances.
YESNO

* I need power.
YESNO

* I have a FREE STANDING banner.
ATTENTION: Hanging, sticking or sticking materials on walls and paintwork of De Belleman is NOT allowed.

* I want to be informed of activities organized by innerTeacher.
YESNO

You can fill in any comments or questions

If desired, attachment (maximum 10mb):
File type: jpg, jpeg, png, gif, pdf, doc, docx, ppt, pptx, ppsx, odt, mp3

By entering the date and sending the form I agree with the House roules. This is also my signature.
* Date _ thus stated truthfully:

Filling in and sending does not mean that your registration is definitive.

If it is no longer possible to offer you a place, the participation fee will be refunded to your account.
Thank you for your assignment, participation and payment.

After a click on 'Send', the text for successful transmission will be placed under that button.
Or ... a message that not all desired fields have been filled in.

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