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Américas regional seminar and
workshop on norms and standards related to the rights of persons with disabilities and
development |
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Américas regional seminar and
workshop on norms and standards related to the rights of persons with disabilities and
development |
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Participant Registration Form |
| Apellido(s) / Nombres Family name(s) / Given names |
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| Nacionalidad / Nationality | |
| Dirección domiciliaria / Residence address | |
| Agencía / Agency | |
| Título actual / Current title | |
| Teléfon / telecopía - fax / correro electronico - e-mail | |
| Número de pasaporte / Passport number | |
| Expedido por / Issued by | |
| Fecha de expedición / Date of issue | |
| Válido hasta / valid until | |
Health statusTo the best of my knowledge I certify that I am medically fit to travel to and from the Seminar and Workshop at Quito and to participate in Meeting proceedings. Signed: Place and Date: |
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