Delegation Number: Country:
Organization:
Contact Person:
Number of Participants: Adults: Students:
A. Participant Registration
ADULTS
1. Name: Sex: male female
Theme Group Registration:
1st Choice: #1 Deserts and Desertification #2 The Desert in Danger #3 Managing Sustainable Environments #4 The Desert Ecosystem #5 Living in the Desert #6 Art in the Desert Environment 2nd Choice: #1 Deserts and Desertification #2 The Desert in Danger #3 Managing Sustainable Environments #4 The Desert Ecosystem #5 Living in the Desert #6 Art in the Desert Environment 3rd Choice: #1 Deserts and Desertification #2 The Desert in Danger #3 Managing Sustainable Environments #4 The Desert Ecosystem #5 Living in the Desert #6 Art in the Desert Environment
Special requests (dietary, medical or other):
STUDENTS
B. Travel Information:
Arrival at Tel Aviv: Date: Time:
Airlines: Flight no: Arriving from:
Departures from Tel Aviv: Date: Time:
Airlines: Flight no: Destination:
C. Delegation Presentation:
1. Presentation Title:
2. Brief Description:
3. Form of Presentation: oral poster video web site other
4. Equipment and/or Space Needs:
Please add any additional requests or information:
D. Optional Post-Conference Trips
Delegates interested in participating in post-conference trip:
1. Name: male female adult student
Trip choice:
2. Name: male female adult student
3. Name: male female adult student
4. Name: male female adult student
5. Name: male female adult student
6. Name: male female adult student
7. Name: male female adult student
8. Name: male female adult student
You can complete your updated form here, or fax or email it to:
Fax: 972-7-6558352 or 972-7-6535225
Email: negev97@environment.negev.k12.il
