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Lausanne 4 Regional Gathering South Asia LSA'23

With your application for Lausanne 4 you are also considered to take part at LSA '23 (Lausanne South Asia 2023)
This form is specifically enquiring about your interest in attending the LSA '23 congress, which will be held from 31st October to 2nd November in Colombo, Sri Lanka.

All participants must bear the cost of traveling and reaching the venue and pay the corresponding registration fee:

Participants from Sri Lanka: Day Scholar 70USD / with Hotel Stay 100 USD
International Participants: Double Occupancy 175USD / Single Occupancy 225 USD
Online Participation: before 31st July: 20 USD / after August 01: 40 USD

PERSONAL INFORMATION

If your name is not pre-filled below, please do not continue with the form. Contact s.asia@lausanne.org for the correct link.

First (Given) Name

Last (Family) Name

Country of Residence

Mobile Number (please include Country Code eg. +94 0123 123 12)

GATHERING PARTICIPATION

I am interested to join LSA'23

in Persononline (20 USD - until July 31st, then 40 USD)

I am from Sri Lanka:

NoYes

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For Sri Lanka residents:

Accommodation costs

I would like to attend but do not need accommodation (Day scholar) - 70USDI would like to attend and need accommodation (Hotel stay) - 100 USD

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Hotel options:

Double Occupancy - 175 USD

Single Occupancy - 225 USD

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SСHOLARSHIP

Will you need scholarship support to cover your airfare and/or visa expenses?

Yes. I understand that Lausanne cannot guarantee a scholarship, but I would like to be put on the waiting list if one becomes available.

No. I plan to cover/fundraise for my own travel expenses.Unknown

Please specify the details, including where you will be traveling from and an estimate of your travel expenses.

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Food Preference

VegetarianNon-Vegetarian

Please list if you have any food allergies here:

Do you have any access requirements you would like us to be aware of?

YesNo

If yes, please explain here:

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Thank you that you are interested to join LSA23. You will receive a confirmation Email with the registration details after the selection.