_________________ 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 PARLIAMENTARY ELECTIONS IN UKRAINE ON 26 MARCH 2006 PLEASE COMPLETE AND RETURN THIS FORM TO THE INTERNATIONAL SECRETARIAT  BY  10 MARCH  2006 Surname:    ................................ ................................ ..... First Name:    ................................ ................................ . Passport Number: ............................  Diplomatic Passport?  (yes/no).................................... (Please fax a copy of your passport to the International Secretariat with this form) Visa needed at the airport (yes/no)…………………………………………………………… Citizenship:    ................................ ................................ . Date of Birth:    ................................ .............................................................. Place 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 (if any):    ................................ ............ Embassy Support:................................   ................................ ...................... (Please indicate if your local Embassy will provide you with a car and an interpreter on Election Day and whether you will be picked-up at the airport by your Embassy)