Participation Form

If you want to participate in one or more activities in the Jubilee Weekend , then you can register using the form below.

  • Participation fee for the seminar is € 5.00
  • Salsa class is from 19:30 to 20:00 on Friday, January 29th and will cost € 3.00
  • Coffee and tea during the breaks are free.

If you have a preference for vegetarian food and / or if you want to participate in the salsa lesson please let us know using the form.

Please fill in your information and check the appropriate boxes before sending.

Logo2-vbi-blauw-400-300AFTER submitting the form below, please transfer € 5,00 and optional € 3,00 salsa tuition costs via PayPal or banktransfer
Bankaccount: NL28 INGB 0001 8909 19, BIC: INGBNL2A  attn Vereniging Basisinkomen, Zeist, NL



Salutation*

First Name*

Last Name*

Address*

Zipcode*

Residence*

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Phone

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Presence*

Salsa lessons on 29th of january

Buffet on 29th of january

Vegetarier in case of Buffet

Allergies in case of Buffet (write them down below)

Quiz*

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