T10 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 15th October 2014 (Extended) 

 

 

    General Details

    1 Name of your national society
    2 Are you attending the T 10 Summit in Sri Lanka YesNo
    Please note that each person who are attending the T 10 Summit should fill a separate form per person.

    General Details

    3 Surname / Family Name (As per in your passport)
    4 Other Given Names
    5 Title
    6 Name you prefer for the Summit
    7 Job title
    8 Date of Birth (DD-MM-YYYY)
    9 Passport No
    10 Date of Issue (DD-MM-YYYY)
    11 Date of Expiry (DD-MM-YYYY)
    12 Place of Issue
    13 Issuing Authority
    14 Address
    15 Gender
    16 Nationality
    17 Mobile
    18 Office Phone No
    19 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

    20 Is this your first visit to Sri Lanka? YesNo
    21 If “No” please state the date (DD-MM-YYYY) & Visa No of the previous visit
    22 Please upload a recent copy of your passport
    (Allowed image types: JPEG,PNG,GIF and BMP Max file size: 2 Megabytes)
    23 Duration of stay in Sri Lanka?

    Dietary & Emergency Details

    24 Do you have special dietary needs?
    25 Are you allergic to any medication?
    26 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 Emergency contact details of the person from originating country. (Please provide mobile numbers and the relationship to the person)

     

    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)

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

    Budget

    We at Sri Lanka Red Cross will take care of your travel, food, hotel and other miscellaneous expenditure within Sri Lanka during the T10 Summit for One individual per national society. However if more people are to take part the cost will approx. 1200 USD.

    34 If you are an extra participant how do you prefer to make payment to the hotel & transport? (Directly or via IFRC) YesNo
    35 If you are an extra IFRC Official please state the budget codes covering your hotel & transport fees
    36 Please upload a recent picture of yourself - (Allowed image types: JPEG,PNG,GIF and BMP Max file size: 2 Megabytes)
    37 Any other questions that you may want clarifications from us

    Visit to Sites

    Once you submit your application I will get in touch with you via email to discuss on your preferred tsunami project sites that you want to visit.

    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