Parliamentary Observer Registration Form
Parliamentary Elections in Ukraine, 26 October 2014
Registration Date:
(dd.mm.yy)
PERSONAL INFORMATION
(Please answer each section clearly, completely and
Family Name:
First Name:
Nationality:
Passport Number:
Passport Type:
Diplomatic Regular Service
use only English transcription)
Mobile in the field:
(country code +number)
Email:
Languages:
ENG RUS FR SP IT GER
CONTACT PERSON
(Person in charge of practical arrangements)
First Name &Surname
:
Mobile:
Email:
Departure
Date
:
(dd.mm.yy)
Departure Time:
(hh:mm)
TRAVEL INFORMATION
Arrival Date:
(dd.mm.yy)
Arrival Time:
(hh:mm)
Arrival Flight:
TRANSPORTATION
To/From the Airport (in
KYIV)
Not Required
(Embassy/ Own arrangements/ etc)
Departure Flight:
Required
DEPLOYMENT ON ELECTION DAY
Preference of Deployment Partner:
(if any)
Car on Election Day
Interpretation on Election
Day
E-day Interpretation
OSCE
OSCE
ENG
RUS
Embassy
Embassy
FR
SP
Own
Arrangements
Own
Arrangements
IT
GER
Participated in the May 2014 EOM to
Ukraine?
If
YES
- which city?
YES
NO
PREFERENCE FOR DEPLOYMENT LOCATION
Kyiv city
Willingness to travel by car outside Kyiv city (up to 90 minutes)
Willingness to overnight outside Kyiv
(The International Secretariat will provide suggestions based on requirements)
Please return this form together with a passport copy by
10 October 2014
to
Ms. Iryna Sabashuk OSCE PA Secretariat tel: +45 33 37 80 47 fax +45 33 37 80 30
OSCE PA
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