OSCEs Parlamentariske Forsamling 2012-13
OSCE Alm.del Bilag 43
Offentligt
Short-Term Observer Registration FormPresidential Elections in Georgia, 27 October 2013Registration Date:(dd.mm.yy)
PERSONAL INFORMATION(Please answer each section clearly, completely andFamily Name:First Name:Nationality:Passport Number:Passport Type:First Name &Surname:Mobile:Email:Diplomatic/Regular/Service
use only English transcription)
Date of Birth:(dd.mm.yy)Mobile in the field:(country code +number)
Email:Languages:E-day Interpretation:ENG –RUS –FR –SP–IT-GER
CONTACT PERSON(Indicate contact details for the person in charge of practical arrangements for your participation)
TRAVEL INFORMATIONArrival Date:(dd.mm.yy)Arrival Time:(hh:mm)Arrival Flight:VISATRANSPORTATIONTo/From the AirportAirportOSCE
Departure Date:(dd.mm.yy)Departure Time:(hh:mm)Departure Flight:EmbassyEmbassyNot NeededOwnArrangements
DEPLOYMENT ON ELECTION DAYPreference of Deployment Partner:(if any)Car on Election DayInterpretation on ElectionDayOSCEOSCEEmbassyEmbassyOwnArrangementsOwnArrangements
Preference for Deployment Place(Please indicate more than one option)AREA*Tbilisi - cityTbilisi surroundingsDushetiGoriBorjomiKutaisi*Akhalkalaki*Batumi*Other (please define)Option 1Option 2Option 3Driving Timen/amax 30 min45 min60 min130 min200 min240 min360 min/flight
*Deployment to Kutaisi, Akhalaki, Batumi will require 1-2 nights out of Tbilisi (nights 26-27 and 27-28 Oct)
Please return this form together with a passport copy byFriday 27 September 2013toMs. Iryna Sabashuk OSCE PA Secretariat tel: +45 33 37 80 47 fax +45 33 37 80 30[email protected]
OSCE PA
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