Portlantis - International educational institutions

Educational institution

Name of educational institution

Educational institution phone number

Contact person

First name

Middle name (if applicable)

Last name

Mobile phone number

Email address

Preferred time to call

Educational institution address

Street

Number

Postcode

City

Invoice details

Invoice to (name/department)

Reference / purchase order number / cost code

Email address for invoice

Invoice address

(Only fill in if different from the visit address)

Street

Number

Postcode

City

Preferred visit date of field trip

Option 1

Option 2

Option 3

Class 1

Class Name

Educational level

Year of group

Number of students

Add another class

Class 2

Class name

Educational level

Year of group

Number of students

Add another class

Class 3

Class name

Educational level

Leerjaar

Number of students

Field trip

To tailor your visit as much as possible to your needs, we have a few additional questions below.

Which part of the day would you like to plan your field trip?

Morning programme

Afternoon programme

Number of lunchboxes (€12,50 each)

Preferred language

I have read the terms and conditions and agree to this

Additional comments / notes on your registration