Boot Camp Registration Form

Dear T10 Summit Participant,

Prior to you proceeding towards answering the long list of questions below, I would like to let you know as to why we are seeking so much of information. The General Details & Visa details are mandatory questions set by the Government of Sri Lanka so that your visa application can be processed without any problem. The remaining questions are just to ensure that we give you a high quality of service during the T10 Summit here in Sri Lanka. While I do understand the list is very long, but please ensure that you answer all the questions with accurate information. If you don’t have all the information do not submit the application half completed. Return back once you have the information.

Many thanks for your support and participation. If you have any queries please don’t hesitate to email me at mahieash.johnney@ifrc.org

Hope to see you soon in Colombo for T10 Summit.

Mahieash Johnney
Coordinator – T10 Summit 

REGISTRATIONS WILL CLOSE ON 21st September 2014 

 

    General Details

    1 Surname / Family Name (As per in your passport)
    2 Other Given Names
    3 Title
    4 Name you prefer for the conference
    5 Job title
    6 Name of your National Society or IFRC Delegation or ICRC delegation or other
    7 Date of Birth (DD-MM-YYYY)
    8 Passport No
    9 Date of Issue (DD-MM-YYYY)
    10 Date of Expiry (DD-MM-YYYY)
    11 Place of Issue
    12 Issuing Authority
    13 Address
    14 Gender
    15 Nationality
    16 Mobile
    17 Office Phone No
    18 Email – Please mention an address you will check regular, as your visa details and approval will be sent to this address -

    Visa

    To know how the special visa process works to Sri Lanka please click here

    19 Is this your first visit to Sri Lanka? YesNo
    20 If “No” please state the date (DD-MM-YYYY) & Visa No of the previous visit
    21 Please upload a recent copy of your passport
    (Allowed image types: PDF,JPEG,PNG,GIF and BMP Max file size: 2 Megabytes)
    22 Duration of stay in Sri Lanka?
    23 Do you have a Sri Lankan Mission in your country? Y/N YesNo
    24 What is the city of the Sri Lankan Mission in your country?

    Dietary & Emergency Details

    25 Do you have special dietary needs? Ex - Vegetarian, Lactose Intolerant
    26 Are you allergic to any medication?
    27 Do you have any health condition, which we need to be aware of? (Please provide details of your nature, so we can provide you with the care you need in case of an emergency, ex – Diabetes, Heart problem)
    28 Have you done the Red Cross First Aid course?
    29 Emergency contact details of the person from originating country. (Please provide mobile numbers and the relationship to the person)

    Language Proficiency

    Please note the operative language for the event will be in English. But we need to know whether you would need translation support.

    Excellent – I don't need translations
    Medium – I can manage but a bit of translations is required
    Poor – Sorry I need translations
    English ExcellentMediumPoor
    French ExcellentMediumPoor
    Spanish ExcellentMediumPoor
    Arabic ExcellentMediumPoor

    Flights

    (Can submit a tentative flight details, and there has to be one in order for us to process your Visa. Do not leave blank or fail to put the details. However if the flight details are going to change, immediately inform me by quoting the Reference Number you received once you submit your application at mahieash.johnney@ifrc.org)

    30 Airline code & number (Ex - For Sri Lankan Airlines Flight 267, the airline code is UL - Write UL 267
    31 Date of Arrival (DD-MM-YYYY)
    32 Arrival Time
    33 Date of Departure (DD-MM-YYYY)
    34 Departure Time

    Budget

    35 Do you have funding to attend this event? YesNo
    36 If you have funding how do you prefer to make payment to the hotel & transport? (Directly or via IFRC)
    37 If you are anIFRC Official please state the budget codes covering your hotel & transport fees

    Hotel Details

    You have a selection of 2 hotels that can be booked. The options are provided, as we understand that most are taking part with limited funding support. The rates for hotels in Colombo are kept at the same rate at 155 USD, however we have negotiated with one hotel, hotel Kingsbury to provide it for 140 USD. There are several budget hotels in Colombo and the best one we can offer will cost 90 USD. All rates are on bed and breakfast basis.

    • Option 1 - The Kingsbury (Location of the event) – Limited amount of rooms during this season. Will secure on first come first serve basis.
    • Option 2 - Hotel Renuka - Budget Hotel, around 15 mins drive from Kingsbury
    Please select your option: Option 1Option 2
    38 Please upload a recent picture of yourself
    (Allowed image types: JPEG,PNG,GIF and BMP Max file size: 2 Megabytes)
    39 Please upload a high resolution picture of your National Societies Logo
    (Allowed image types: JPEG,PNG,GIF and BMP Max file size: 2 Megabytes)
    40 Any other questions that you may want clarifications from us
    By clicking on submitting please note that you assure that the information provided by you are accurate and up to date. Providing inaccurate information would hinder the process of your application to the boot camp. When making queries or informing us on any changes, please quote the "Reference Number" mentioned in the email which you will receive once you click on the below button.

    Contact Us

    Sri Lanka Red Cross Society
    National Headquarters
    106, Dharmapala Mawatha,
    Colombo 07, Sri Lanka

    [T] (94) 11 2691095 , (94) 11 2691095

    [F] (94) 11 2682675

    [E] info@redcross.lk