To register, please email the form below (one per registrant) to Andrea Lomanto at quest@opencenter.org, or mail to the N.Y. Open Center, Esoteric Quest, 22 East 30th Street, NYC 10016.  For questions or comments, please email quest@opencenter.org or phone Andrea at +1-212-219-2527, ext. 101.  Your registration is complete only once you receive your confirmation, by post or email.


    Date:
    Name:
    Traveling Companion(s) for Pre and/or Main Conference room shares:
    Address:
    City:
    State/Province:
    Zip/Postal Code:
    Country:
    Telephone (Day):
    Telephone (Evening):
    Email:
         

    Emergency Contact Information:
    Name:
    Phone:
    Email:
         

    For those of us joining our Post-Conference Catalonia Journey:
    Name exactly as it appears on your passport:
    Passport Number:
    Country of Issue:
    Date of Issue:
    Date of Expiry:
    Birthday:
         

    Main Conference Accommodations:
    Please number in order of preference. Some room options are quite limited, but we will do our best to accommodate your wishes.
    Accommodation Option
    (pending availability)    		 Cost for five full
    nights    		 Order of preference
    (1-6 where 1 being highest and 6 lowest)
    Shared room with private bath at the Hotel Bristol $275 per person
    Single room with private bath at the Hotel Bristol $375
    Shared room with private bath at the du Soleil le Terminus $350 per person
    Single room with private bath at the du Soleil le Terminus $525
    Shared room with private bath at the Trois Couronnes $450 per person
    Single room with private bath at the Trois Couronnes $600

    Post- Conference Accommodations:
    SingleShared
    If rooming with a traveling companion during the post-conference, let us know who they are:
    Need separate beds? YesNo
    If requesting roommate arrangements to be made by the Open Center for either pre, main or post-conferences, please let us know your:
    Age:
    Gender: MaleFemale
    Smoker: YesNo
    If not smoker, willing to share with smoker?:
    Do you snore: YesNo
         

    Conference Payment:
    Check as many options as apply.  Full payment is required to register.  Please note that it will be possible to arrange for monthly automatic credit card payments to facilitate registration. Contact Andrea Lomanto at quest@opencenter.org or at +1-212-219-2527, ext. 101, to discuss payment plan options before registering.
     
    *Please note that we can accept conference registration until Friday, April 17, 2015.
     
    Pre-Conference Tour Registration: Montségur and Puivert - 3rd of June 2015
    Pre-Conference Tour Registration: $225
    Two nights hotel in Carcassonne for Pre-Conference Tour:
    Basic accommodations
    single accommodations: $150shared accommodations: $110 per person
    Midrange accommodations
    single accommodations: $210shared accommodations: $140 per person
    Upgraded accommodations
    single accommodations: $240shared accommodations: $180 per person
     
    Main Conference Registration: Carcassonne – 4th - 9th of June 2015
    by March 20, 2015: $2395by April 17, 2015: $2695
     
    Main Conference Accommodations
    (4th - 9th June)    		 $
    Optional One Night Hotel in Carcassonne (if NOT attending Pre-Conference):
    3rd of June 2015
    Basic accommodations
    With single accommodations: $75With shared accommodations: $55 per person
    Midrange accommodations
    With single accommodations: $105With shared accommodations: $70 per person
    Upgraded accommodations
    With single accommodations: $120With shared accommodations: $90 per person
     
    Post-Conference Registration: Provence – 9th –15th of June 2015
    With single accommodations: $2850With shared accommodations: $2375 per person
    Post-Conference Registration: Catalonia, Spain – 9th –14th of June 2015
    With single accommodations: $1850With shared accommodations: $2150 per person
    Post-Conference Registration: Catalonia with Barcelona Extension – 9th - 16th of June 2015
    With single accommodations: $2950With shared accommodations: $2450 per person
         
    Registration Total
    Pre-Conference Tour of Montségur and Puivert $
    Pre-Conference Accommodations $
    Main Conference in Carcassonne $
    Main Conference Accommodations
    (4th - 9th June)    		 $
    Additional Conference Accommodations
    (3rd of June)    		 $
    Post-Conference Journey into Provence $
    Post-Conference Journey into Catalonia, Spain $
    Post-Conference Registration: Catalonia with Barcelona Extension $
    Total Amount $
       
    Credit Card #:
    Exp. Date: /
    Check #:
      (made payable to the New York Open Center)
         

    Refund Policy:
    A full refund, less a $200 processing fee, will be offered for cancellations made before
    Friday, March 20, 2015.
         

    Please check:
    I am aware of my need to arrange for travel insurance in the event of any unforeseen circumstances taking place either before or during our travels.
         

    Meal options:

    		  
    Vegetarian (includes dairy and eggs)Fish and ChickenNon-vegetarian
    Please indicate any special dietary concerns, which we will accommodate wherever possible:
         

    How did you first hear about this conference?:
    Postcard
    Open Center catalog
    Brochure (by mail or picked up where? )
    Website (which one? )
    Online Search
    Friend (do you know how they found out? )
    Facebook
    Open Center E Newsletter
         

    Conference Welcome Packet:
    A welcome packet that includes information about your arrival in Catania, travel tips and paperwork to return to the Open Center will follow. Please let us know how you would like to receive this: EmailMail
         
    Additional notes or comments:
      Please feel free to leave any additional notes or comments here. We will get back to you as soon as possible. Thank you for joining us!
         
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