OSCEs Parlamentariske Forsamling 2013-14
OSCE Alm.del Bilag 1
Offentligt
Short-Term Observer Registration FormPresidential Elections in Tajikistan, 6 November 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*Dushanbe - cityDuschanbe surroundingsKurgan-TyubeRudakiKulob*Shartuz*Khujand*Gorno Badakhshan (Khorog) **Other (please define)Option 1Option 2Option 3Driving Time –Good weathern/amax 60 min2 hrs2 hrs4 hrs4 hrs 30 min6 hrs 30 mins1-1,5 hourflightDriving Time –Bad weathern/an/a3.5 hrs3.5 hrs7 hrs7 hrs 30 min12+ hrs
*Deployment toKulob, Shartuz, Khujandwill require 1-2 nights out of Dushanbe (nights 5-6 and 6-7 Nov)** Please note: This option will depend on flight schedules and weather conditions.1-2 nights stay out of Dushanbe(nights 5-6 and 6-7 Nov)tobe expected.
Please return this form together with a passport copy by16 October 2013toMs. Iryna Sabashuk OSCE PA Secretariat tel: +45 33 37 80 47, fax +45 33 37 80 30[email protected]OSCE PAPage 1 of 1Record #: _________
