foireauxsavoirsdakar.com

REGISTRATION

Travel Profile Form

Full Name (as appears on Passport) *

First

Middle

Last

Phone number *

Name of Organization *

Affiliation / Designation *

Address of Organization *

Departure City (Which city you are travelling from?) *

Departure Airport Code

Arrival Date (At Dakar, Senegal) *

Departure Date (From Dakar, Senegal) *

Do you require Dakar, Senegal VISA ? *

Any valid visa: US, Schengen, UK etc.

Do you have valid travel insurance for this trip? *

Who is sponsoring your trip ?

Passport No. *

Nationality *

Issue Date *

Expiration Date *

Current Address / Country of Issue

Address Line 1

City

State / Province / Region

Country

Date of Birth

Sex

Contact number

Name

Relationship

Contact details

Address

Telephone No(s)

Email *

Seat Preference

Meal Preference

Comments: (Frequent Flyer Information details, if any etc.)