BaltiMix-2021

PARTICIPANT (full legal name of organisation)*

Company and bank details *

represented by (position, chief's name)*

acting on the basis*

Mailing address*

Phone*

E-mail*

Contact person*

Surname and name of the participant 1 *

Choose variant:
select from the drop-down list*

Position of participant*

E-mail*

Mobile phone*

Surname and name of the participant 2

Choose variant:
select from the drop-down list

Position of participant

E-mail

Mobile phone

Surname and name of the participant 3

Choose variant:
select from the drop-down list

Position of participant

E-mail

Mobile phone

BOOK A ROOM IN HOTEL "ONEGIN 4*":*
YES
NO

PLEASE, CHOOSE HOTEL and ROOM:
Standart Single
Studio Single

Type the characters you see in the picture*

Application for participation