BMF Coordination Meeting - Participant Registration

	Expert Group Meeting on the Promotion of Social and Economic Participation of Persons with Disabilities towards the Biwako Plus Five Bangkok, Thailand, 27-28 February 2007

Return to Main page	Participant Form Please printout, and type or print
In order to enable ESCAP to facilitate administrative arrangement on your behalf, kindly complete and return this form by 9 February 2007 directly to Ms Keiko Osaki, Chief, Population and Social Integration Section, Emerging Social Issues Division, Economic and Social Commission for Asia and the Pacific, 6th Floor, United Nations Building, Rajadamnern Nok Avenue, Bangkok 10200, Thailand, fax: (66-2)288-1030 Email: escap-esid-psis @ un.org
1. Given name:
2. Family Name:
3. Sex:	___ Male ___ Female
4. Official Designation:
5. Contact Address:
	Telephone:
	Fax:
	Email:
6. Passport Details:	Nationality:
	Date of birth:
	Place of birth:
	Passport No.:
	Date and place of issue:
	Date of Expiry:
7. Type of disability (if you wish to let us know)

Title and signature of the designating official Date

Participant Form