Jump to Navigation
World Student Christian Federation - North America
Living Justice. Living Faith. An Inclusive Community.
Search form
Search
Registration Form - NARA 2011
Submitted by
Alice
on Mon, 06/13/2011 - 19:58
Given Name
*
Family Name
*
Citizenship
*
Date of Birth
*
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
Gender Identity?
Address
*
Telephone Number(s)
*
Email Address
*
Are you a member of SCM-Canada or SCM-USA?
*
SCM-Canada
SCM-USA
Not active in either movement
Are you from an outside organization? (NGO, other SCM, etc)
*
Study area / occupation
Church membership
Do you have a valid passport? (All Canadians must have a valid passport to attend the conference, for legal reasons.)
*
Yes
No
Do you require assistance in obtaining a visa or invitation letter?
*
Yes - please give details below in the "Further remarks and special needs" field
No
Passport Number
*
Issued at (place)
*
Date of issue
*
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Date of expiry
*
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
Do you have any dietary requirements?
*
What is your personal motivation to take part in this Regional Assembly?
*
How will you bring this experience back to your home community and make change? How will you build support for this?
*
Further remarks, special needs
Main menu
Home
|
Get involved
|
Events
|
Publications
|
About Us
|
Contact Us
|
Donate
|
Links
|
Blog