CIO.GAL/25/15
9 March 2015
   
ENGLISH only

	
Protection of safety and integrity of journalists in the OSCE region
Belgrade, 26-27 March 2015		
R E G I S T R A T I O N  F O R M

Ms.		Mr.   	Family Name: (as per passport)	First Name: (as per passport)	

Title/Position:	

Institution/ Department:	

Contact Address:	

Mobile No. with all prefixes:	E-mail address:	

Section II (only if support for visa is required)

Date of Birth:	Nationality:	
		
Passport No:	Type of Passport:	
	 Normal	 Service Passport	
 Diplomatic Passport 	
Date of Issue:	Date of Expiry:	
		
Departure airport: 		Airport of arrival: 		
Date:		Time or Flight No:		Date:		Time or Flight No:		
Stopover: 		Stopover: 		
Date:		Time or Flight No:		Date:		Time or Flight No:		
Additional comments:	

Please return the completed Registration Form by Tuesday, 17 March 2015 
to Ms Ivana Ivanov – E-mail: ivana.ivanov@mfa.rs 
Tel: +381 11 306 8424