Empowered 21 African Congress
Accommodation Booking Form
Name (as per Passport)
*
FULL First Name
Last Name
Gender
Male
Female
E-mail
*
Contact Number
*
Name of Church / Ministry
Do you need assistance with Flight Bookings?
*
Yes
No
Arrival Date
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2018
2017
Year
Flight Number (if available)
Departure Date
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2018
Year
Flight Number (if available)
Accommodation Dates
*
Do you need help with an invitation letter for Visa Applications?
*
Yes
No
Country of Origin
Country you will Travel From
Do you need transfers to and from the airport?
*
Yes
No
Do you have a Diplomatic Passport?
Yes
No
Would you like to share a room/unit with someone?
Yes
No
Sharing Options (Add names below)
With my Spouse (Double Bed)
With someone of the same gender (Twin Beds)
Children
FULL First Name and Surname of person sharing (as per Passport)
Are you traveling with a minor(s)?
Yes
No
Would you like to register a group booking?
Yes
No
Group Details
Total
Number of Married Couples
Number of MEN with Single Rooms
Number of MEN who wish to share a Twin Room
Number of WOMEN with Single Rooms
Number of WOMEN who wish to share a Twin Room
Number of Minors in Group
Are you part of a group travelling together?
No
Yes
Group Leader Details
First Name
Last Name
Group Booking Code
Submit
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