Test All about you: First, Last Name* Street Address: City, State, Zip Code: Country: Mobile, Home Phone: Email* Role in PTPI: I am minor of age* Yes No PTPI chapter Dietary restrictions: Physical challenges: *For minors (younger than 18), please submit a Parental Permission Form. See website resource centre. Payment Options Please choose one of the two payment options listed below. I wish to pay by credit card online (Visa or Master Card only) I wish to pay by bank transfer directly to the hosting chapter European Conference 2017 – Fees Early Bird Participation - Fee registration and payment before July 1, 2017 - 210 USD* 205 euro* Standard Participation - Fee Registration and payment before July 14, 2017 - 240 USD* 235 euro* European Conference 2017 - Student Fee Registration and payment before July 14, 2017 - 167 USD* 152 euro After July 28, 2017 - European Conference Fee Registration and payment possible until 1 August - 290 USD* 285 euro* Non-member Fee - 310 USD 305 euro *Included in the European Conference 2017 Fee Day 1 All included activities/meals Day 2 All included activities/meals Day 3 All included activities/meals Day 4 All included activities/meals European Council Meeting and include meals Not Included*:Travel to/from Armenia, sleeping accommodation, entrance to the Ararat Brandy factory (varies from the chosen brandy for tasting), optional program components, post-conference tour Optional Programs. If you would like to sign up for one or more optional program(s), please indicate this below. Optional Programs If you would like to sign up for one or more optional program(s), please indicate this below. I. Pre-conference Date Day 1 - Optional Program 1/meals - 65 USD / 60 euro Day 2 - Optional Program 2/meals - 75 USD / 70 euro Day 3 - Optional Program 3/meals - 85 USD / 80 euro II. Post-Conference Tour Deadline Program 16.06.2017 Post-Conference Tour – Early Bird** - 400 USD / 395 euro 14.07.2017 Post-Conference Tour – Standard Fee** - 430 USD / 425 euro 28.07.2017 Post-Conference Tour – Non-Member Fee** - 480 USD / 475 euro Student Fee - 278 USD / 263 euro **Included in the Post-Conference Tour Fee Private transport by bus throughout the entire trip 1 night accommodation in single room in 4* or 5* hotels including breakfast (Jermuk Olympia Hotel: http://www.hotels.am/jermuk-olympia-hotel http://www.jermukolympia.am/en/content/1/ or Jermuk Armenia Hotel: http://www.jermukarmenia.com/) Professional guide in English throughout the trip Entrance fees for the museums All lunches and dinners Not Included*: your travel or health insurance, accommodation costs for the 1st and last night, cable car tickets in Tatev.