CARIBBEAN AWARD SUB-REGIONAL COUNCIL AFFIX ONE PHOTO HERE (Electronic Accepted)
C.A.S.C. EXPEDITION DOMINICA JULY 29-AUGUST 13, 2011 REGISTRATION FORM
Participant Silver Participant Gold
Exp. Assessor Trainee
Staff / Leader
PLEASE READ CAREFULLY AND THEN COMPLETE AS FULLY AS POSSIBLE, USING BLOCK LETTERS. ENCLOSE TWO RECENT PASSPORT SIZE PHOTOGRAPHS OF YOURSELF; ONE SHOULD BE ATTACHED TO THE TOP OF THIS FORM AND THE OTHER TO THE MEDICAL FORM. THE REGISTRATION FEE IS US$200.00. COMPLETED FORMS AND AT LEASE HALF THE REGISTRATION FEE SHOULD BE RETURNED BY AUTHORISED AWARD OFFICIAL TO REACH DOMINICA 1ST MAY. (See information on page 5) NAME: MR. /MRS. /MISS: ……………………………………………………………..……….. ADDRESS: ……………..………………………………………………………………………… ………………………………………………………………………..…….……….. E-MAIL ADDRESS: ……………………………………………………………………………… TEL: …………………………..
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HAVE YOU TRAVELLED OR LIVED OVERSEAS? 1
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