[Cz-L] Reunion Registrations Clarification

Dear Czernowitzers,

Some of you seem to be having problems sending us or accessing the forms
on the web. Therefore here are the two ways in which Jerome has kindly
put them onto the website.
They can be copied and pasted onto an email as per below

OR,- from the Word version,- copy and save onto a Word doc., then sent
to us as a Word attachments,- only as Word.doc, not as any other
program.

However, they are also here for you to fill in and then forward to us by
email,- or you may like to print them out and send them to us by fax AS
PER THE ADDRESSES AT THE BOTTOM OF EACH.

Best regards,
Malvina Malinek & Luba German
Melbourne, Australia.

PLEASE NOTE: FILL IN BOTH FORMS IF RELEVANT AND SEND THEM TO THE
ADDRESSES at the bottom of each form.
I.e. the Vienna one to Malvina Malinek ;<hegma2_at_pacific.net.au> or fax:
(61 3) 9824 0216.

for Czernowitz, send to:
  - Luba German (Email: luba_at_breakawaytravelshop.com.au)
Ph: 03 9824 1136 Mobile: 0418 560 290 Fax: 03 9826 8814

------------------------------------------------------------------------
---------------

CZERNOWITZERS' LIST REUNION 2006.
VIENNA 25/05/06 to 01/06/06
Date ____________________
                                        FORM1. VIENNA REGISTRATION FORM

NAME (S)
________________________________________________________________________
______________________________________________________________________
HOME ADDRESS
________________________________________________________________________
___
________________________________________________________________________
______________
PHONE _______________________ MOBILE ___________________ FAX
_____________________ ORIGINAL NAME (if changed by deed poll)
________________________________________________________________________
______________
ORIGINAL MAIDEN NAME
________________________________________________________________________
______________
PLACE AND CITY OF BIRTH
____________________________________________________________________
LANGUAGES_______________________________________________________________
____________________

VIENNA HOTEL STEFANIE Single--------- Double-----------Triple--------
ARRIVAL DATE_____________________________
DEPARTURE if not continuing to
Czernowitz_____________________________________

MEAL REQUESTS - Kosher _____________ Vegetarian ______________ Other
________________

N.B. PLEASE EMAIL TO MALVINA: <hegma2_at_pacific.net.au>
      OR: FAX TO: -(61 3) 9824 0216.
------------------------------------------------------------------------
-----------

                                Form 2.CZERNOWITZ.

CZERNOWITZ 01/06/06 to 09/06/06

World Organization of CZERNOWITZ - BUKOVINA and surrounding districts
together with

The World Federation of Jewish Fighters, Partisans and Camp Inmates
Israel,
are holding a world wide conference to mark the

THE 65th COMMEMORATION OF THE DEPORTATION OF THE JEWISH PEOPLE FROM
  CZERNOWITZ BUKOVINA AND THE SURROUNDING DISTRICTS TO THE CONCENTRATION
CAMPS IN
  TRANSNISTRIA - MOGILOV PODOLSKY AND OTHERS CAMPS.

        VIENNA 25/05/06 to 01/06/06
        CZERNOWITZ 01/06/06 to 09/06/06
Date ____________________

PASSENGER REGISTRATION FORM

NAME
________________________________________________________________________
______

ADDRESS
________________________________________________________________________
___

________________________________________________________________________
______________

PHONE _______________________ MOBILE ___________________ FAX
_____________________

ORIGINAL NAME (if changed by deed poll)
________________________________________________________________________
______________

ORIGINAL MAIDEN NAME
________________________________________________________________________
______________

PLACE AND CITY OF BIRTH
________________________________________________________________________
______________

PASSPORT DETAILS
_________________________________________________________________

________________________________________________________________________
______________

VISAS REQUIRED
____________________________________________________________________

MEAL REQUESTS - Kosher _____________ Vegetarian ______________
Other ________________

INSURANCE DETAILS
________________________________________________________________

PRE-EXISTING ILLNESSES
____________________________________________________________

________________________________________________________________________
______________

NAME OF GENERAL PRACTIONER AND ANY RELAVENT SPECIALISTS

________________________________________________________________________
______________

MEDICARE NO
_______________________________________________________________________

PRIVATE HEALTH FUND
______________________________________________________________

Breakaway International Travel Pty Ltd
Licence 30014
P O Box 120 Malvern 3144
Australian Co-Ordinator - Luba German (Email:
luba_at_breakawaytravelshop.com.au)
Ph: 03 9824 1136 Mobile: 0418 560 290 Fax: 03 9826 8814

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