USA EOM 2016
Observer Registration Form
UNITED STATES OF AMERICA
General Elections 8 November 2016
Registration Date:
(DD-MM-YYYY)
PERSONAL INFORMATION
(Please answer each section clearly, completely and use only English transcription)
Family Name:
Nationality:
Mobile in the field:
(country code +number)
Passport Number:
Email:
Passport Type:
Diplomatic/Regular/Service
First Name:
CONTACT PERSON
(Indicate contact details for the person in charge of practical arrangements for your participation)
First Name &Surname:
Mobile:
Email:
TRAVEL INFORMATION
(Observers are advised to arrive to Washington, D.C. on 4 November 2016 to participate in briefings on 5-6 November and
can depart on 9 November 2016)
Arrival Date:
(dd.mm.yy)
Arrival Time:
(hh:mm)
Arrival Flight:
Departure
Date
:
(dd.mm.yy)
Departure Time:
(hh:mm)
Departure Flight:
ARRANGMENTS ON ELECTION DAY
Preference of Deployment Partner:
(if any)
Car on Election Day
Interpretation from EN
on Election Day Needed
Embassy
YES
(please specify)
Own
Arrangements
NO
OSCE
DEPLOYMENT LOCATION
Washington D.C.
Willingness to overnight outside Washington, D.C.
(The International Secretariat will provide the list of deployment destinations)
Please return this form together with a passport copy by
Wednesday 5 October 2016
to
the OSCE PA International Secretariat
fax +45 33 37 80 30
OSCE PA USA EOM 2016
DATE_________
RECORD #_________