Request for lodging with a family

Logging accommodation in a hosting family is free and includes room and breakfast from June 15th to 22nd, 2008.

The information written on the registration forms is confidential and will not be used for any other purpose than to handle your reservation.

To cover the administration charges , you are invited to make a donation by sending a cheque payable to the IEC 2008, 1073 boulevard René-Lévesque Ouest, Québec (Québec) G1S 4R5, Canada.

Personal Data

First Name:

Last Name:

Age: years

Gender: men women

Email:

Door number:

Street:

City:

Country:

Postal code / Zip code:

Area code and phone:

Name of group leader : Find my group leader.

Accommodation requested

Occupation : single double other person’s name:

Spoken languages : English French Spanish Other(s) specify:

Smoker : no yes

Optional specifications

* Leave the field empty if you have nothing to mention.

* Animal allergies:

* Food allergies:

* Restricted mobility:

* Special needs: