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NVIC Application form for accommodation
Please fill out this form to book a guest room at NVIC. Your reservation is not final until you receive a confirmation email. Please see all rates on our website.
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Email Address
*
Your answer
Phone number
*
Your answer
Date of birth
*
MM
/
DD
/
YYYY
Place of birth
*
Your answer
Nationality
*
Your answer
Passport Number
*
Your answer
University Affiliation
*
University of Leiden
University of Amsterdam
Free University of Amsterdam
University of Utrecht
University of Groningen
Radboud University
KU Leuven
Ghent University
Other:
Field of Study
*
Your answer
Status
*
Student
Academic Staff / Researcher
Other:
Purpose of the visit
*
Your answer
Date of arrival at NVIC
*
MM
/
DD
/
YYYY
Date of departure from NVIC
*
MM
/
DD
/
YYYY
If traveling alone, are you willing to share your room with another visitor?
*
Yes
No
Other:
Do you wish to be picked up from the airport by our driver
*
Yes
No
If yes, please provide full flight details
Your answer
Remarks:
Your answer
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