_________________ Raadhusstraede 1, 1466 Copenhagen K., Denmark Phone: +45 33 37 80 40   -   Fax: +45 33 37 80 30   -   E-mail [email protected] -   Website: www.osce.org/pa OSCE PA SHORT-TERM OBSERVER REGISTRATION FORM PRESIDENTIAL ELECTIONS IN KYRGYZSTAN ON 10 JULY 2005 PLEASE COMPLETE AND RETURN THIS FORM TO THE INTERNATIONAL SECRETARIAT  BY 17 JUNE 2005 Surname:    ................................ ................................ ..... First Name:    ................................ ................................ . Passport Number: ............................  Diplomatic Passport?  (yes/no).................................... (Please fax a copy of your passport to the International Secretariat with this form) Citizenship:    ................................ ................................ . Date of Birth:    ................................ .............................................................. Arrival Date:…………………………Arrival Time:  .............................................................. Flight Number:    ................................ ........................................................... Departure Date:................................  Departure Time:........................................................... Flight Number:    ................................ ........................................................... Languages:    ................................ ................................ .. (Please remember: English is the official language of the Delegation) Preference for Place of Deployment:........................................................................................ Preference of Deployment Partner:.......................................................................................... Embassy to provide airport transportation? (Yes/No):.......................................................... Car/driver needed on election day? (Yes/No): ……………………………………………….. Interpreter needed on election day? (Yes/No): ………………………………………………..