Ticket Registration

We are nearing capacity for CONVERGENCE! Please email sita@PlantTeachers.com for accommodation availability before sending payment.

Please fill in your details and select your accommodation type


Contact Information

E-mail:

First Name:

Last Name:

Name you would like to be called:

Address Details:

 

Street - Number and Name:

City:

State / Region:

Country:

Zip / Postal Code:

Telephone Numbers:

 

Home:

Work:

Mobile / Cellular:

Other:

Any persons names who you would prefer to share accommodation with?
How did you hear about CONVERGENCE?
Comments:
Suggestions:
If you wish to remit payment via wire transfer, bank check or money order, please email for more information at:
Sita@PlantTeachers.com
Do you need information about Extended Stays or Lodging in Iquitos before or after CONVERGENCE? Yes No
Extended Stay
Lodging in Iquitos
Accommodation / Ticket Type

Regular:

 
 
Please double check that all your information is correct