ITALY
–
LEOM - 2018
Observer Registration Form
Limited Election Observation Mission to ITALY
Parliamentary Elections 4 March 2018
Date of Registration:
(dd.mm.yy)
PERSONAL INFORMATION
(Please answer each section clearly, completely and use only English transcription)
Family Name:
Nationality:
Passport Number:
Passport Type:
First Name:
Mobile in the field:
(country code +number)
Email:
Diplomatic/Regular/Service
Working Language(s):
EN FR RU DE IT SP
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 Rome on 1 March 2018 to participate in briefings on 2-3 March 2018 and can depart on 5 March 2018)
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 on
Election Day
For OSCE E-day
Interpretation:
(
please mark ONE)
EMBASSY
OSCE
OWN
ARRANGEMENTS
Embassy
OSCE
Own
Arrangements
EN
DE
FR RU
SP
DEPLOYMENT LOCATION*
(please mark up to 3(three) locations in order of preference)
Rome city
Rome surroundings (up to 60 minutes)
Milan
Turin
Bologna
Naples
Palermo
*Deployment to Milan, Turin, Bologna, Naples, Palermo will require overnight stay for 2 nights (3-5 March 2018)
at the deployment destination.
Please return this form together with a passport copy by
Thursday 8 February 2018
to
the OSCE PA International Secretariat
fax +45 33 37 80 30
OSCE PA ITALY LEOM 2018
DATE_________
RECORD #_________