Meal Reservation Form for Archamps Lodgers who will Pre-pay by Fax

Submitted by admin on Tue, 06/09/2009 - 07:59

Print and fax the following COMPLETED form to the Health Ministries Department at +1-301-680-6707 with your credit card information. PLEASE PRINT CLEARLY. After completion of the form click on the Print Icon on the upper right corner of the page and proceed with printing.

Personal information

Your full name: *

Your email: *

Meals, Tuesday, July 7 through Friday, July 10 – (All meals will be prepared at Collonges)

Number of box lunches for Tuesday, July 7 (10.00 Swiss Francs):

Number of dinners for Tuesday, July 7 (15.00 Swiss Francs):

Number of box lunches for Wednesday, July 8 (10.00 Swiss Francs):

Number of dinners for Wednesday, July 8 (15.00 Swiss Francs):

Number of box lunches for Thursday, July 9 (10.00 Swiss Francs):

Number of dinners for Thursday, July 9 (15.00 Swiss Francs):

Number of box lunches for Friday, July 10 (10.00 Swiss Francs):

Number of dinners for Friday, July 10 (15.00 Swiss Francs) :

Meals (Saturday, July 11 - Available to all)

Free bus transport to all who choose to go to Collonges for the Saturday afternoon meetings.

Number of Lunches for Saturday, July 11 (10.00 Swiss Francs):

Number of EXTRA Dinners for Family members & guests, July 11 (15.00 Swiss Francs):

Total number of meals and total costs

Total number of lunches Tuesday through Saturday:

Total price of lunches in Swiss Francs:

Number of lunches X 10 Swiss Francs.

Total number of dinners Tuesday through Saturday :

Total price of dinners in Swiss Francs:

Number of dinners X 15 Swiss Francs.

Billing Information

Name as it appears on your credit card:

Type of card:

Please print the type of card with capitals (VISA, MASTER CARD, DISCOVER, AMERICAN EXPRESS)

Credit card number:

Expiration Date:

Security Code (three numbers on the back):

Billing Address of Card Invoices

Street:

Apt.:

City:

State/Province:

Country:

Postcode:

How to send this form

After completion of the form click on the Print Icon in the upper-right corner of this page, then proceed with printing from your browser's menu (FILE and PRINT). Finally, fax the printed form to +1-301-680-6707.

Recordings

Submitted by admin on Thu, 09/17/2009 - 09:52

Recordings of the Conference both Plenary and Workshops are available at HealthMinistries.com our primary Health Ministries Website. Click here.

Primary links

Webforms

Recordings

Recent comments