2016 OSCE Asian Conference
Strengthening Comprehensive Security 
Bangkok, Thailand, 6 - 7 June 2016		

REGISTRATION FORM
	
Please complete by typing in the appropriate cells; to tick the check boxes, please double click on them and choose the “checked” option
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:	

Citizenship:	

Mobile No. with all prefixes, including national code:	E-mail address:	
		
In an event of emergency please contact:	E-mail address:	

Participation in the excursion to the Sampran Model in Nakhon Pathom Province	
I will participate alone  	I will participate and will be accompanied  	I will not participate  	

During the Conference, I will stay at the The St. Regis Hotel Bangkok    and will be accompanied by person(s)
Alternatively, I can be reached under the following address / tel. / fax #:	

	

Please complete this form electronically, save it with your FAMILY NAME
and submit not later than 23 May 2016 by e-mail to:
pm-extco@osce.org