Fill in your details below to complete your registration.

Onboarding

First name

Middle name

Last name

Date of birth

Email

Phone Number

Social Security

Address

Street

Complement

City

State

ZIP Code

Country

Company

Role

Passport number

Type of Visa

Are you aware of the U.S. entry requirements related to COVID?

Yes

No

Do you have a complete vaccination certificate?

Yes

No

Do you have Flight Insurance

Yes

No

What's your english level?

Basic

Intermediate

Fluent

Native

Emergency Contact Phone Number

Full Name of Emergency Contact Person

City, Day, and Time of Your Flight Arrival

Airline and Flight Number(s)

City, Day, and Time of Your Flight Departure

Airline and Flight Number(s)

Your Shoe size

Blood Type

Do you have any disabilities?

Do you have any illnesses or special needs?

Any observations or requests?

We need a photo of you to be used on your identification badge. It should have a 3×4 ratio, be of good quality, and in image format (jpg, png, tiff). To submit, click the button next to this message and attach it to the email that will open. If you encounter any issues, simply send it to the email: leanimmersionweek@gmail.com.

SEND PHOTO

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