OVERVIEW+PROGRAM | ITINERARY | PACKAGES | REGISTRATION

REGISTRATION

Corpus Medicorum encourages doctors and medical students not to forgo their substantial talents during the long years of medical training. It also provides a highly satisfying creative outlet for practicing medics to balance their demanding professional lives.

Our Mission is to blend Medicine, Community, Philanthropy, and Music. Please join us on our Grand European Tour!

For all travel enquires please email anj@worldwidetravel.com.au. I am in Canada visiting family so with the time difference email is the best method of contact until September.

Fields marked with an * are required

Name

First Name

Last Name

Email Address

Phone

Postal Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

PERSONAL INFORMATION

Name

(As shown on passport)

First Name

Last Name

Title

Date of Brith

Instrument that you play

(if you are a supporter please leave blank)

PASSPORT DETAILS

Nationality of Passport

Place of Brith (As shown on passport)

Passport Number

Passport Issue Date

YYYY

Passport Expiry Date

YYYY

airline details

Seating Preference

Special Meal (Specify)

Airline Club Membership

Please Select

Membership Number

Will anybody be travelling with you?

** If yes, please fill in separate form for each traveller **

PACKAGE

(a) Are you a scholarship student?

If YES, skip to (d)

(b) Which package(s) are you most interested in booking?

Please select

Spirito Package (A)

Spirito Package (B)

Mezzo Package (A)

Mezzo Package (B)

Espressivo Package (A)

Espressivo Package (B)

Additional Information:

Please select

Europe

Singapore

(d) Which city in Australia will you be departing from?

PAYMENT OPTIONS

Registration is $650pp for musicians and $150pp for accompanying travellers.
This is waived for children under 12 and medical students on scholarships.

Payment Method

Fill in the fields below if paying by Credit Card.
If selecting Direct Deposit submit your registration and follow the Direct Deposit instructions.

Credit Card Type

I hereby authorize you to debit my credit card as follows:

Number

Expiry Date

CCV #

Name Printed on Card

Amount

Being Payment for

To Agree to this Charge Please Type your Name

First Name

Last Name

Direct Deposit Details

Bank: ANZ
BSB: 013 445
Account: 382144068
Name: World Wide Travel
Ref: Your Surname-CM2018