2012 OSCE Mediterranean Conference 
“Economic co-operation with Mediterranean Partners in the democratic transition processes and political reforms”
Rome, Italy, 30 − 31 October 2012 

Registration Form

Please complete in capital letters
Family Name:	Ms.		Mr.		First Name:	
     	     	

Institution/State:	
     	

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

Street or Mail address:	City Code 	City	Country:	
     	     	     	     	
Tel. No. with all prefixes:	Fax No. with all prefixes:	
     	     	
Mobile No. with all prefixes:	E-mail address:	
     	     	

Date:	     		Signature: 	     	

Please submit this form not later than 18 October 2012

by fax or e-mail
Fax:   +43-1 514 36- 6250  	e-mail:    pm-ext-coop@osce.org 

PLEASE NOTE:
-	For security reasons, failure to register within the deadline will prevent the possibility of having granted access to the premises of the venue.
-	Participants from the diplomatic corps in Rome are also requested to register within the deadline with the OSCE Secretariat.
-	Delegations failing to register with the OSCE Secretariat within the deadline will not be provided with a nameplate at the main table.