90th District Conference and Assembly Dar es Salaam ... fileBahari Beach Hotel Belinda Jangwani...
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Registration Number:.................................... Date received:.........../............./................... DELEGATE INFORMATION: (Please Tick all Appropriate) Past District Governor Past AG President Rotarian Rotaractor 1. Last Name 2. First Name 3. Name to show on Badge/Call Name Interactor AG Other (specify)................................................................................................... 4. Rotary/Rotaract/Interact club 5. Classification 6. Spouse/Guest Name (If accompanying) 7. City 8. Country 9. Position in Rotary/Rotaract/Interact 10. Paul Harris Award (Mark as appropriate) 11. E-mail Address Yes Multiple/Major/etc 12. Mobile Phone 13. Alternate Phone ( )- ( )- 18. Please specify special dietary needs 14. Arrival Date 15. Road travel/ Flight details (if applicable) 16. Departure Date 17. Road travel/ Flight details (if applicable) Vegetarian Other (please specify) 19 (a) Accommodation 19 (b) Accommodation required type 19 (c) Hotel (see reverse for details) Check In Date:................................................... Yes No Single Double Triple Check Out Date: ................................................ 20.Calculate your charges SIGNATURE:………………………………………………….…….. DATE:……………………………………………………………… 1 Registration F orm Declaration: I confirm that the above information is true, accurate and complete. I also guarantee to the conference registration committee that I will pay the amount i have indicated above for my registration for the 90th District Conference & Assembly, Rotary District 9211 in the manner shown. 90th District Conference and Assembly Dar es Salaam, Tanzania 13th - 16th May, 2015 Registration No. of Pax Category ROTARIAN SPOUSE/GUEST ROTARACTOR INTERACTOR Number, rate & type of room TOTAL AMOUNT PAYABLE Please calculate the above with relevant date qualification and totals. Please note qualification date will be confirmed on date the form is received at our office. No. of Nights Single: Rate $_________Double: Rate $__________ Triple: Rate $__________ ACCOMODATION SELECTION 100% advance payment required to secure reservation 160 160 90 75 190 230 190 230 90 100 90 100 Total Charges Early Bird Registration Fee (Per Person) Payable by December 31, 2014 2015 Registration Fees (Per Person) Payable by February 28, 2015 2015 Registration Fees (Per Person) Payable March 1st onwards, Credit Card Information: Please provide credit card information for billing ONLY if registration payment mode is through credit card and submit copies of credit card (both sides) with form: Please debit my Credit Card Account - Indicate type of Credit Card (mark as appropriate): VISA MASTER CARD CREDIT CARD NUMBER: ___________________________________ EXPIRY DATE: ______/______ SECURITY NUMBER ______________________________ NAME ON CARD: _________________________________________AMOUNT TO DEBIT: US$ ____________ (Surcharge of upto 3.2% & financial levies will apply to total of item no.xxx) SIGNATURE OF CARD HOLDER: _____________________________ (NB: Registrations sent via email will infer and constitute authority and signature) 21. Credit Card Authorisation & Conditions (only if paying by Credit Card)
Transcript of 90th District Conference and Assembly Dar es Salaam ... fileBahari Beach Hotel Belinda Jangwani...
Registration Number:....................................
Date received:.........../............./...................
DELEGATE INFORMATION: (Please Tick all Appropriate)
Past District Governor Past AG President Rotarian
Rotaractor
1. Last Name 2. First Name 3. Name to show on Badge/Call Name
Interactor
AG
Other (specify)...................................................................................................
4. Rotary/Rotaract/Interact club 5. Classification 6. Spouse/Guest Name (If accompanying)
7. City 8. Country 9. Position in Rotary/Rotaract/Interact
10. Paul Harris Award (Mark as appropriate) 11. E-mail Address
Yes Multiple/Major/etc
12. Mobile Phone 13. Alternate Phone
( )- ( )-
18. Please specify special dietary needs 14. Arrival Date 15. Road travel/ Flight details (if applicable)
16. Departure Date 17. Road travel/ Flight details (if applicable) Vegetarian
Other (please specify)
19 (a) Accommodation 19 (b) Accommodation required type 19 (c) Hotel (see reverse for details)
Check In Date:...................................................Yes No Single Double Triple
Check Out Date: ................................................
20.Calculate your charges
SIGNATURE:………………………………………………….…….. DATE:………………………………………………………………
1
Registration F orm
Declaration: I confirm that the above information is true, accurate and complete. I also guarantee to the conference registration committee that I will pay the amount i have indicated above for my registration for the 90th District Conference & Assembly, Rotary District 9211 in the manner shown.
90th District Conference and AssemblyDar es Salaam, Tanzania
13th - 16th May, 2015
Registration No. of PaxCategory
ROTARIAN
SPOUSE/GUEST
ROTARACTOR
INTERACTOR
Number, rate & type of room
TOTAL AMOUNT PAYABLE Please calculate the above with relevant date qualification and totals.Please note qualification date will be confirmed on date the form is received at our office.
No. of Nights
Single: Rate $_________Double: Rate $__________ Triple: Rate $__________
ACCOMODATION SELECTION100% advance payment required to secure reservation
160
160
90
75
190 230
190 230
90 100
90 100
Total ChargesEarly Bird Registration Fee
(Per Person) Payable by
December 31, 2014
2015 Registration Fees (Per Person)
Payable by February 28, 2015
2015 Registration Fees (Per Person) Payable March 1st
onwards,
Credit Card Information: Please provide credit card information for billing ONLY if registration payment mode is through credit card and submit copies of credit card (both sides) with form:Please debit my Credit Card Account - Indicate type of Credit Card (mark as appropriate): VISA MASTER CARD
CREDIT CARD NUMBER: ___________________________________ EXPIRY DATE: ______/______ SECURITY NUMBER ______________________________
NAME ON CARD: _________________________________________AMOUNT TO DEBIT: US$ ____________ (Surcharge of upto 3.2% & financial levies will apply to total of item no.xxx)SIGNATURE OF CARD HOLDER: _____________________________ (NB: Registrations sent via email will infer and constitute authority and signature)
21. Credit Card Authorisation & Conditions (only if paying by Credit Card)
Registration Number:....................................
Date received:.........../............./...................
23. Payment Mode
$
• It is recommended that Hotel bookings be done through the conference registration or accommodation committees.
120 $105
$100
$115
$120
$ 64 $80
$150
$135
$110/$130 (Triple)
$120
120
138
120
20
90
90
32
White Sands Hotel Jangwani beach
Jangwani beach
Kunduchi
Kunduchi
Ubungo
Jangwani beach
Jangwani beach
Jangwani beach
Jangwani beach
Blue pearl Hotel
Kunduchi beach Hotel
Bahari Beach Hotel
Belinda
Jangwani Hotel
Giraffe Hotel
SeaScape Hotel
Please note:
a) 50usd is to be deposited at check in and refundable at check out.
b) The above rates are enjoyable a week before the conference and a week after.
1
Registration F orm
US$only)
Bank Transfer (Payable in US$only)
Mobile Money (Applicable to ONLINE REGISTRATION ONLY
25. Conference Accomodation
26. For additional information, please contact:
26. Bank Details:
Beach Comr
Hotel Name Location No. of Rooms Single Rate Double Rate
• There will be airport shuttles, please confirm your date and time of arrivals and departures
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CHAIRMAN RTN. SHARMILA BHATT MOBILE: +255 784 321 909EMAIL: [email protected]
TREASURER RTN. SHARMILA BHATT MOBILE: +255 784 321 909EMAIL: [email protected]
REGISTRATION RTN. RAJU SHETH MOBILE:+255 784 323 [email protected]
ACCOMMODATION RTN.NADINE ATALLAH & ANNE SAELSMOBILE: +255 752 270 777 & +255 752 033 466EMAIL: [email protected]
A/c Number: 3718000006A/c Name: Rotary Conference CollectionBank: Centenary Bank, Corporate BranchSwift Code: CERBUGKA
22. Payment Mode
Cash (Payable in US$ only)
24. Registration Guidelinesi. Full payment with the duly completed registration form is required to secure confirmations of both conference space and accommodation (payments may be made by cash, credit cards, wire transfer or bank drafts). Any applicable charge on bank transfer and draft would be payable by the applicant.
ii. Cancellations postmarked by April 15th, 2015 will receive a refund less USD 40.00 processing fee. Cancellations or changes in registration must be in writing and will not be accepted after April 15th, 2015.iii. Cancellation is USD 40.00 - for the registration cost only. Hotel cancellation would be as per the Hotel’s policy.
• It is recommended that hotel bookings be done through the Conference Registration in order to secure discounted rates and to confirm your bookings.
• The Accommodation committee has secured preferred rates at several similar rated Beach Hotels. Room allocation will be effected on first-come-first serve basis (All room rates based on Standard Rooms types)
• Rates quoted below are on Bed and Breakfast basis [Incl. Taxes]. Lunch & dinner served at the designated conference venue.
• 100% Advance payments required to secure and ensure hotel booking reservation (Conditions for cancellation apply).
• 90th DCA Accommodation/Registration Committee(s) to have discretion on room allocation at designated conference hotels – subject to availability
• Transportation coordinated ONLY to-and-from the 90th DCA designated hotels
• For any special needs contact designated accommodation committee [ref No.25]
• Registration will close when capacity of conference is reached.
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Debit or Credit card payment(Payable in US$ only)
Bank Transfer (Payable in US$ only)
23. Conference Accomodation
26. Bank Details:
25. For additional information, please contact:CHAIRPERSONRTN. SHARMILA BHATT MOBILE: +255 784 321 909EMAIL: [email protected]
TREASURERRTN. HITESH SHAH & RTN. ANWER RAJPAR MOBILE: +255 754 288 441 & +255 752 033 466EMAIL: [email protected]
REGISTRATIONRTN. RAJU SHETH MOBILE:+255 784 323 435EMAIL: [email protected]
ACCOMMODATIONRTN. NADINE ATALLAH & RTN. ANNE SAELSMOBILE: +255 752 270 777 & +255 754 378 363EMAIL: [email protected]
For Payments within Tanzania:
Account Name: Rotary 90th DCABankers: Bank M (Tanzania) LtdSWIFT: BNKM TZ TZBranch: KisutuUS $ A/C No: 0250025982
For Payments within Uganda:
Account Name: Rotary Conference CollectionAccount Number: 3718000006Bank: Centenary BankBranch: Corporate BranchSwift Code: CERBUGKA
134.50
*Hotels that are close to the Conference Venue
Hotel Name LocationDistance from
venue Single Rate Double Rate Triple Rate
*White Sands Hotel
Jangwani beach
Jangwani beach
Jangwani beach
Kunduchi
Ubungo 17.2km
8.6km
8.3km
7.3km
7.2km
8.6km
8.6km
9km
8.3km
13.2km
Jangwani beach
Jangwani beach
Jangwani beach
Jangwani beach
Jangwani beach
Blue Pearl Hotel
*Kunduchi Beach Hotel
*Belinda -Beach
*Belinda -Main
*Jangwani Hotel
*Giraffe Hotel
*SeaScape Hotel (Standard room)
*SeaScape Hotel (Sea Viewing room)
*Beach Comber
Bamaga, MwengeKebby’s Hotel
163
113
83
83
133
138
123
118
88
113
83
137.50
106.50
91.50
101.50
65.50
68.50
91.50
91.50
111.50
81.50
61.50
Jangwani beach
8.6km
8.6km*Landmark Hotel (Deluxe room)
*Landmark Hotel (Standard room) Jangwani beach
153
118100.50
121.50
*Bahari Beach Hotel Kunduchi 4.6km 153121.50
