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First Name : |
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Family Name : |
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Gender : |
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Date of birth (mm/dd/year) : |
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Age : |
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Passport no. (Confidential) : |
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Passport valid through (mm/dd/year) : |
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Issued in : |
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Address (Str./City/St/Zip/Country) : |
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Telephone : |
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Cell phone : |
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Email : |
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Do you want to share your address? : |
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Do you want to share email? : |
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Type of room you want : |
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Roommate/partner name (if applicable) : |
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Need us to find roommate? : |
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Need extra night(s) at hotel in Cluj? : |
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If, YES, how many night(s) and date(s) : |
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Smoker : |
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Vegetarian : |
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If vegetarian please specify : |
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Food allergie(s) : |
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Health Conditions; allergy(ies), asthma, diabetes, other(s) : |
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Language(s) you speak : |
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Is this 1st trip in Romania? : |
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Person(s) to contact if emergency : |
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Relationship with this person(s) : |
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Phone number of this person(s) : |
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email of this person(s) : |
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Name and number insurance policy : |
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Date of arrival in Cluj : |
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Date of departure from Cluj : |
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Detailed itinerary : |
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Questions or comments : |
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