• Salutation* Please choose Mr. Mrs.
• First Name*
• Last Name*
• Residence*
• E-Mail Address*
• confirm E-Mail Address*
• Mobile Number*
• Are you an employee of Roche?* Please choose Yes No
• Why are you interested in a tour?

Companion

Please enter the name of your companions. The name you entered above you do not have to reenter here.

• First Name
• Last Name
• First Name
• Last Name
• First Name
• Last Name
• First Name
• Last Name
• First Name
• Last Name
• First Name
• Last Name
• First Name
• Last Name
• First Name
• Last Name
• First Name
• Last Name
• First Name
• Last Name

Security Code*

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