OSCE Security Days 2016 
Rome, 4 March 2016

Registration Form

Please submit this form not later than 24 February 2016 by e-mail to securitydays@osce.org
In the subject line of the e-mail please indicate: 2016 SD in Rome
Name of State / Organization / Institution: 	
     	
Please tick one of the categories below:	
 Participating State 	 Partner for Co-operation	 International Organization	 Academic Community      Media 	 NGO    	 OSCE                         	 Business Community	

Family Name:	Ms.		Mr.		Given Name(s):	
     	     	

Title / Position as to appear on the list of participants:	
     	

Mobile No. with all prefixes, including national code:	E-mail address:	
     	     	
Tel. No. with all prefixes, including national code:	Fax No. with all prefixes, including national code:	
     	     	

I require a special assistance when accessing the venue, due to the following physical need:	
     	

Please be reminded that access to Palazzo della Farnesina will be granted only to registered participants and upon presentation of a valid identity document with a picture.