In order to serve your needs during the conference in Dakar, Senegal, please fill out the following survey/questionnaire. When you have completed that process either print and fax the completed form to (954) 925-0097, or save this document in html format
(html file only), then send it to ricelamar@bellsouth.net as an attached document. Thank you!



TRAVEL SURVEY
RiceLamar World Travel
For

WORLD CONGRESS OF PANAFRICANS / CONGRES MONDIAL DES PANAFRICAINS CONFERENCE

DAKAR, SENEGAL, DECEMBER 27 - 31 2007

Welcome!
Name*
FIRST NAME
 
  LAST NAME
Address*


CITY/VILLE

STATE

 
COUNTRY

 
CANADIAN PROVINCE

 
 ZIP CODE

 
HOME PHONE OR CELLPHONE NUMBER

EMAIL ADDRESS (if you have one)

 
 WHAT IS YOUR GENDER?


Are you traveling with: Spouse/Companion , Other, ? Specify the number of participants in each group: Infants , 2-12yrs , 13-17yrs , 18-24yrs , 25-50yrs ,  50+ yrs,   

Due to the serious nature of the conference, youth, under the age of 18 should not be in attendance during conference workshop events.  All conference participants are required to register.


Do you need child caring services during conference hours?

If so, how much are you willing to pay per day?

Have you and other traveling companions, 18 yrs and older, completed the conference registration, including paying all required deposits?   Yes , No
AIR TRAVEL:
What is your preferred date of departure to Dakar for the conference?
(Conference begins 8:30 am on December 26. Please indicate 1st and 2nd choices)

December 23rd , December 24th , , December 25th , , December 26th

What is your preferred return date from Dakar?
(Conference will end at 5 pm on December 31, 2007. Please indicate 1st and 2nd choices)

January 1 , January 2 , , January 3 or later; please give date .

MISCELLANEOUS:
Diet! What foods are your restricted from consuming (either due to religion, or health)?
(Make sure that content falls within box)
    


Would you like to take local tours while your are attending the conference? Yes ,  
No


ACCOMMODATIONS:
Would you be willing to share accommodations with an individual outside of your traveling party (singles may double your cost)?

Yes ,   No 

If yes,  
with opposite sex:   Yes ,    No,  Doesn't matter .


What type of bedding arrangements do you need?

1 twin size bed.

1 Queen size bed. 
2 twin size beds.

2 double/full size beds.

2 double/full plus 1 sofa bed or roll away bed.  


Do you require any special accommodations? Yes ,    No 

If yes, please indicate your need:

Wheelchair accessibility.  

Sign language translator.

Material in large print.  

Other, please explain    



Where do you prefer to stay (
please rate choices as 1st, 2nd, or 3rd choice)?


At the hotel where the conference is being held even if cost is up to 50% more than the least expensive option.

At the hotel where the conference is being held even if the cost exceeds 50% more than the cost of the least expensive option.    

At a less expensive hotel that is within walking distance of where the conference is being held.

At a less expensive hotel within a 30 minute drive from where the conference is being held and transportation is being provided (Only clean and secure accommodations will be recommended).

 At a less expensive hotel within a 30 minute drive from where the conference is being held and you will provide your transportation (Only clean and secure accommodations will be recommended).

At a private home with a local family (You must be responsible for transportation to the conference site). Yes ,    No 


Please indicate the importance of the following amenities by placing #1, 2, or 3.

          #1  Necessary (willing to pay a little more to have it)
          #2  Not necessary but would like it if it does not cost more.

          #3  Not interested!

Internet access on premises.

Internet access from the room.

Restaurant on premises.

A variety of restaurants on premises.

Eating places within walking distance (1/4 mile).

Room Service - for ordering food to the room.

Housekeeping - regular changing of linen and towel provided.

Air Conditioned room.

Private Bath.

Gym/workout facilities on premises.

Access to public transportation other than private cabs.

Phone in room.
Laundry facilities on premises.

Close to market place for fresh foods.
Refrigerator in room.

Microwave in room or easily accessible.
Kitchenette (stove, oven, refrigerator and microwave).

Iron and ironing board in room.


How much do you expect to pay per night for accommodations! $

Multilingual?
Indicate languages that you speak, and understand:

English (Do you read and write in English?) 

French (Do you read and write in French?)  

Spanish (Do you read and write in Spanish?) 

Portuguese (Do you read and write in Portuguese?)  

African Languages: please indicate which language(s)  



What is your primary reason for attending this conference?
 (Make sure that content falls within box)
    

Please share any suggestions and or comments:
(Make sure that content falls within box)
     
 

 


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