2013 OSCE Mediterranean Conference
“Enhancing the Role of Women in Public, Political and Economic Life”
Monaco, 28 - 29 October 2013

Registration Form
Section I – to be completed by all participants
Participating State  | Partner State  | International Organization  | OSCE Institution  | NGO/Academia 	
Name of State / Institution:  	

Family Name:	Ms.		Mr.		Given Name(s):	

Title / Position as to appear on the list of participants:	

Mobile No. with all prefixes, including national code:	E-mail address:	
		@	
Fax No. with all prefixes, including national code:	Contact details at home in the event of an emergency:	

Arrival	Flight #:		Departure	Flight #:		
Date: 	Oct. 2013	Time:		Date:	Oct. 2013	Time:		

Participation in the cultural programme on 27 October 2013	
I will participate alone  	I will participate and will be accompanied  	I will not participate  	

During the Conference, I will stay at the Le Méridien Beach Plaza Hotel     and will be accompanied by ______ person(s)
Alternatively, I can be reached under the following address / tel. / fax #:	

Section II – to be completed by participants requiring visa, and submitted with a copy of relevant pages of the travel document 
Nationality	Current country of residence	Date of birth	
		Day	Month	Year	

Passport number	Country of issue	Passport type	Expiry date	
		Diplomatic	National	Other	Day	Month	Year	

 
Date:			Signature: 		

Please submit this form not later than 7 October 2013 by fax or e-mail
Fax:   +43-1 514 36- 6250  	e-mail:    pm-ext-coop@osce.org