Registration Form Booking / Register / Payment made by transfer until 15 March with proving document by email to: detox@simplysentient.org IBAN: PT50 0070 2810 0070130018 18 SWIFT: BESCPTPL BANK: NOVO BANCO ACCOUNT NAME: MIGUEL CORREIA FERREIRA Prices for DESIGN FOR DIVINITY : 10-20 April, 2020: 990€ First and Last Name Email address (required) Gender (required) ---MaleFemale Date of Birth (mm-dd-yyyy) Telephone Passport No. Country of Residence ---AfghanistanAlbaniaAlgeriaAmericaAndorraAngolaAntiguaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBissauBoliviaBosniaBotswanaBrazilBritishBruneiBulgariaBurkinaBurmaBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCroatiaCubaCyprusCzechDenmarkDjiboutiDominicaEast TimorEcuadorEgyptEl SalvadorEmirateEnglandEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreat BritainGreeceGrenadaGrenadinesGuatemalaGuineaGuyanaHaitiHerzegovinaHollandHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshallMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapuaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSamoaSan MarinoSao TomeSaudi ArabiaScotlandScottishSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomonSomaliaSouth AfricaSouth SudanSpainSri LankaSt KittsSt LuciaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTobagoTogoTongaTrinidadTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited KingdomUnited StatesUruguayUSAUzbekistanVanuatuVaticanVenezuelaVietnamWalesWelshYemenZambiaZimbabwe Which retreat would you like to attend: ---RETREAT DESIGN FOR DIVINITY 28/12/2018- 01/01/2019 - 400€ Additional Requirements, Comments or Questions:
