Berrinche ambiental inscripcion2011

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Este documento es un formulario de inscripción para un grupo o organización que desea participar en un evento. Solicita información sobre el responsable del grupo, los integrantes del grupo incluyendo datos personales, habilidades artísticas, propuestas para espectáculos o talleres, necesidades técnicas, organización general como transporte y alojamiento, y disponibilidad para ser voluntario antes del evento.

Formulario de Inscripción
Por favor enviar a esas direcciones:elberrincheambiental@gmail.com

Grupo u Organización

Responsable del Grupo
Fecha de
Nombre y Apellidos
Nacimiento
Correo Electrónico Nacionalidad

No teléfono No de pasaporte

Integrantes del Grupo
Fecha de No de Grupo
Nombre y Apellidos Sexo Nacionalidad
nacimiento Pasaporte sanguíneo

En caso de
Correo Vegetariano
No de Teléfono Alergias emergencia
Electrónico (si)/(no)
llamar a

elberrincheambiental.blogspot.com

Fecha de Correo
Nombre y Apellidos Nacionalidad No de pasaporte No teléfono
nacimiento Electrónico

En caso de
Grupo Vegetariano
Genero Alergias emergencia
sanguíneo (si)/(no)
llamar a

Propuesta Artística
Marcar con una
Habilidades X
Especificar las habilidades

Disciplina Circense ( )
Teatro ( )
Zancos ( )
Acrobacia ( )
Música / Danza ( )
Mimo / Payaso ( )
Poeta / Cuenta Cuentos ( )
Otros ( )

Propuesta de Espectáculo

Propuesta de Taller
Tenemos dos opciones para la realización de talleres:
• Intervención en comunidades ( )
• Talleres antes del foro ( )
Elegir la opción de su agrado con una x y describir abajo que tipo de taller ofrecen

Necesidades Técnicas

elberrincheambiental.blogspot.com

Organización General
Transporte Personal ( ) Colectivo ( ) Cuanto vale?

Traemos tiendas de acampar Sí ( ) No ( ) Para cuantas personas?

Comentarios
Se quieren añadir algo, pueden hacerlo aquí

Voluntarios
En Enero, necesitaremos su apoyo.
Por favor, escribir si alguien del grupo viene antes del encuentro hacer voluntariado. Especificar la fecha en que
llegara y también llenar la ficha para voluntariado que se puede encontrar en el sitio web:
elberrincheambiental.blogspot.com

elberrincheambiental.blogspot.com

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Berrinche ambiental inscripcion2011

1. Formulario de Inscripción Por favor enviar a esas direcciones:elberrincheambiental@gmail.com Grupo u Organización Responsable del Grupo Fecha de Nombre y Apellidos Nacimiento Correo Electrónico Nacionalidad No teléfono No de pasaporte Integrantes del Grupo Fecha de No de Grupo Nombre y Apellidos Sexo Nacionalidad nacimiento Pasaporte sanguíneo En caso de Correo Vegetariano No de Teléfono Alergias emergencia Electrónico (si)/(no) llamar a elberrincheambiental.blogspot.com

2. Fecha de Correo Nombre y Apellidos Nacionalidad No de pasaporte No teléfono nacimiento Electrónico En caso de Grupo Vegetariano Genero Alergias emergencia sanguíneo (si)/(no) llamar a Propuesta Artística Marcar con una Habilidades X Especificar las habilidades Disciplina Circense ( ) Teatro ( ) Zancos ( ) Acrobacia ( ) Música / Danza ( ) Mimo / Payaso ( ) Poeta / Cuenta Cuentos ( ) Otros ( ) Propuesta de Espectáculo Propuesta de Taller Tenemos dos opciones para la realización de talleres: • Intervención en comunidades ( ) • Talleres antes del foro ( ) Elegir la opción de su agrado con una x y describir abajo que tipo de taller ofrecen Necesidades Técnicas elberrincheambiental.blogspot.com

3. Organización General Transporte Personal ( ) Colectivo ( ) Cuanto vale? Traemos tiendas de acampar Sí ( ) No ( ) Para cuantas personas? Comentarios Se quieren añadir algo, pueden hacerlo aquí Voluntarios En Enero, necesitaremos su apoyo. Por favor, escribir si alguien del grupo viene antes del encuentro hacer voluntariado. Especificar la fecha en que llegara y también llenar la ficha para voluntariado que se puede encontrar en el sitio web: elberrincheambiental.blogspot.com elberrincheambiental.blogspot.com

Berrinche ambiental inscripcion2011

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