Application
for
"Dine with the Danes"
In order to match you with your host family - please fill in all details below. Thank you.
Party of : female
male
Age:
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20 - 29
30 - 39
40 - 49
50 - 59
60 - 70
over 70
Party of: girls
boys
Age:
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0 - 5
6 - 10
11 - 14
15 - 19
First name:
Surname:
Street:
Postal Code:
City:
Country:
Tel:
Fax:
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Hobbies:
Profession:
Arrival date:
Arrival time:
Departure date:
Request for specific date:
Staying in
Hotel
Camping
Youth hostel
Staying in private home - c/o Name
Street:
Postal Code:
City:
Smoker:
Yes
No
Allergies - Which?
Handicap (Wheelchair etc.) - Which?