Brussels Group

Please complete the form below to register for the:

March for Europe 2017

Brussels Group

Rome, 24-26 March 2017

<div class="powermailheading">Your personal data</div>

Title*

Name*

Surname*

Date of birth*

Nationality

<div class="powermailheading">ID Document used to travel to Rome</div>

Type*

Number*

Expiry date*

<div class="powermailheading">Contact details</div>

Email*

Phone

<div class="powermailheading">Professional information</div>

Position

Organisation

<div class="powermailheading">Participation conditions (single rooms are temporarily no longer available) </div>

All prices below include travel by plane to Rome and acommodation as follows:

Type of accommodation	UEF or JEF members	Non members
Bunk beds: 2 nights in a hostel (4-6 beds per room), breakfast included	200€	250€
2 nights in a hotel room (double or twin), breakfast included	250€	300€
2 nights in a hotel room (single)	275€	325€

I would like to stay in a

I would like to share my room with (if applicable)

I am happy to be contacted about future Federalist events and activities. (You may unsubscribe at any time).*

Don't fill this field!