OSCE Parliamentary Observer Registration Form
Parliamentary Elections in Tajikistan, 1 March 2015
Application Date:
(dd.mm.yyyy) ___________________________________
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)
Date of Birth:
(dd.mm.yy)
Mobile in the field:
(country code +number)
Email:
Languages:
ENG –RUS –FR –SP–IT-GER
CONTACT PERSON
(Indicate contact details for the person in charge of practical arrangements for your participation)
First Name &Surname
:
Mobile:
Email:
TRAVEL INFORMATION
Arrival Date:
(dd.mm.yy)
Arrival Time:
(hh:mm)
Arrival Flight:
VISA
TRANSPORTATION
To/From the Airport
Airport
Not Required
(Embassy/ Own arrangements/ etc)
Departure Date
:
(dd.mm.yy)
Departure Time:
(hh:mm)
Departure Flight:
Embassy
Required
Not Needed
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
PREFERENCE FOR DEPLOYMENT LOCATION
Dushanbe city
Willingness to travel by car outside Dushanbe (up to 90 minutes)
Willingness to overnight outside Dushanbe
(The International Secretariat will provide suggestions based on requirements)
Other (please define)
Please return this form together with a passport copy by
6 February 2015
to
Ms. Iryna Sabashuk OSCE PA Secretariat tel: +45 33 37 80 47, fax +45 33 37 80 30
OSCE PA
RECORD#: _________ DATE: __________