FIPFA TRAVEL REQUEST

FIPFA BoardRefereeClassificator

Firstname

Name

Email

Telephone (ex. : +33 6 77 87 9900)

Event

Your city of departure (Ex. : Orlando, FL)

Destination (ex. : Paris, France)

Departure date

Return date

Do you need airport transfers ?
YesNo

Do you need an hotel room ?
YesNo

Do you want to book a specific hotel ?please indicate the hotel name here

Are you a wheelchair user ?
Electric wheelchairManual wheelchairNo wheelchair

Please indicate here your special needs and wheelchair specification (dimension, weight, battery type):

Your passport

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