ANNEX 1

OSCE HIGH‑LEVEL CONFERENCE ON
TOLERANCE AND NON-DISCRIMINATION
(INCLUDING HUMAN RIGHTS YOUTH EDUCATION ON
TOLERANCE AND NON-DISCRIMINATION)

Tirana, 21 and 22 May 2013

Registration Form

Please submit this form not later 14 May 2013 by e-mail to elke.lidarik@osce.org

Please complete in capital letters

Family Name:	Ms.		Mr.		Given Names:	
     	     	

Representing:	
Country/Name of Organization/Name of Institution:

Please tick one of the categories below:
 Participating State             Partner for Co-operation         International Organization     
 Academic Community       Business Community              NGO      
 OSCE Secretariat             OSCE Field Operation             OSCE Institution       
 Other:      	

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:	
     	     	
Nationality	Current country	Date of birth	
	of residence	Day	Month	Year	
     	     	     	     	     	
Passport number	Issued by	Passport type	Expiry date	
		Diplomatic	National	Other	Day	Month	Year	
     	     							
Arrival 	Flight #:	     	Departure 	Flight #:	     	
Date: 	     	Time:	     	Date:	      	Time:	     	

In Tirana during the event, I will stay at: