Physical Attendance Registration

Participant

Event

Personal Information

Country / Organization of Representation

Title

H.E

Mr.

Ms.

Dr.

Prof.

Family Name

First Name

Prefered Name on Badge

Affiliation

Official Title

Office Address

Gender

Email

Phone NumberPlease type +country code followed by the phone number, ex: +123 456 7890

Fax NumberPlease type +country code followed by the fax number, ex: +123 456 7890

Delegation Contact Point

Name

Email

Phone NumberPlease type +country code followed by the phone number, ex: +123 456 7890

Fax NumberPlease type +country code followed by the fax number, ex: +123 456 7890

Passport

Passport No.

Date of Issuance

Date of Expiry

Itinerary & Accomodation

Arrival

Flight No

Date Arrival

Time Arrival (ETA as of Ticket in Central Indonesian Time)

Departure

Flight No

Date Departure

Time Departure (ETD as of Ticket in Central Indonesian Time)

Accomodation

Accomodation

The Meru Sanur

Bali Beach Hotel Sanur

Dietary Restriction Information

Dietary Restriction

Special Dietary Requirement

No Red Meat

No Chicken

No Fish

No Eggs

No Pork

No Dairy Products

I am a vegetarian but I eat fish

Others

*If applicable, please select your strict dietary requirement by ticking the square

Strict Dietary Requirement

Vegan (I eat only plant food and plant products. I do not eat animal foods, eggs or dairy)

Halal (I require a special meal to be prepared for me from a Halal kitchen)

Kosher (I require a special meal to be prepared for me from a Kosher kitchen)

Celiac Disease (I am allergic to wheat, rye, oats or barley and any food containing gluten)

Others

*If applicable, please select your strict dietary requirement by ticking the square

Other Strict Dietary Requirment

BDF REGISTRATION FORM –PARTICIPANT PHYSICAL ATTENDANCE

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