Towards Car-Free Cities III - Registration Form
- Prague 2003 - Programme - Programme Details - Proceedings - Transcripts
This form should filled out and returned to: Car Busters Conference, Kratka 26, 100 00 Prague 10, Czech Republic or via e-mail to info@carbusters.org. Please use one form per person. Please apply as soon as possible, but there is no need to use environmentally unfriendly express mail service. Women are especially encouraged to apply.
Personal Details:
First name:
Family name (last name):
Country:
Age:
Sex: Male / Female
Postal address:
Telephone:
Fax, if any:
E-mail, if any:
Group Details:
Group/NGO name, if any:
Position with group/NGO, if any:
Group/NGO website, if any:
I would like to arrive at the conference before breakfast/lunch/dinner (circle one) on __________ [date] and leave after breakfast/lunch/dinner (circle one) on __________ [date].
Motivation:
Attendance is limited to approximately 75 participants. Therefore a selection process will determine who should have priority to attend. Priority will be given to those demonstrating an active and long-term commitment to alternative transport(ation) and/or car-free cities, or can otherwise contribute valuably to the conference programme. Due to funders' requirements, we will also prioritise Europeans under age 30, especially from NIS (former Soviet) and SEE (Southeast Europe) countries.
Based on the above, please tell us about what you're working on and why you'd like to attend:
Programme Participation:
O I'd like to make a presentation or lead a workshop/discussion during the conference. Here I'll describe what I'd like to do:
O Therefore I need the following technical equipment:
O I'd like to join a "task group" and help out with planning and logistics on a topic such as facilitation, note-taking/documentation, photography/video, cultural programme/entertainment, etc. My preference is:
Languages:
English will be the primary working language of the conference, but we will offer translation assistance where possible to allow for maximum participation by all.
Please state your level of fluency in English and any other languages:
O I can help translate during the conference from/to ____________________ [language(s)] to/from English.
Accommodation:
O I need hostel-type accomodation at Toulcuv Dvur Ecological Centre from the evening of March 16 to the morning of March 22 (cost included in registration fee; priority accommodation here given to participants staying for the entire conference).
O I will find my own accomodation.
O I would like help finding accommodation from the night of __________ [date] through the night of __________ [date]. My preference would be:
O a home stay with a Prague resident
O a hotel (Penzion Rosa, 200 metres from conference venue), at my own expense (700 CZK/night; cheaper if sharing a double).
Dietary Information:
From dinner on Sunday, March 16, to breakfast on Saturday, March 22, three vegetarian/vegan meals a day are provided, plus some snacks (there's also an on-site natural food shop, plus several other shops within a close walk).
I prefer vegetarian / vegan (select one).
O I have the following special dietary needs/food allergies:
Registration Fees:
Late registration rates now apply. At the full rate, it will cost 100 EUR (3,200 CZK) to attend the conference for the week, including food, accommodation and a one-year subscription to Car Busters magazine (no joke). A reduced rate will be offered to Central and Eastern Europeans and those in greatest need - as well as those only attending for one or two days. After your application/registration is accepted, you will be informed of the exact registration fee, which could vary depending on the success of our fundraising efforts. Payment will be accepted in EUR or CZK (cash only) upon your arrival at the conference.
Travel Reimbursement:
Some level of travel reimbursement will be available (for Europeans only; sorry), especially for presenters and those in greatest need. No travel reimbursement will be provided for participants who lack travel tickets FOR THEIR FULL VOYAGE (return/round-trip). These tickets (used and unused) will be collected on the first day of the conference and returned after photocopying.
O I absolutely need partial reimbursement of travel expenses. Here I will argue my case:
Entry Visas:
Citizens of the European Union, the United States, the Baltic states, Bulgaria, Croatia, Hungary, Poland, Romania, Slovakia, Slovenia, Switzerland and many other countries DO NOT NEED visas to enter the Czech Republic. (See the complete list of visa waiver countries.) Citizens of Albania, Australia, Canada, Macedonia, Russia (and former Soviet republics), Turkey, Yugoslavia and various countries outside Europe DO NEED entry visas.
O I need an entry visa for the Czech Republic; please help me obtain one.
Date of birth:
Nationality:
Passport no.:
Place issued:
Date issued:
Valid until:
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