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A- Delegation

Are you a member of a delegation?

 Yes No 
Delegation
    

B- Information on the participant or the accompanying person
(This form should be filled for each accompanying person)
  
Type of registration Participant Accompanying person   
Gender Monsieur   Madame    Mademoiselle
Other title (precise)
Surname            
First Name      
Nationality          
Position      
Organisation/Institution
Professional address
Zip code        
City         
Country             
Phone number
Direct line
Mobile phone
E-mail         
Fax
Web site  
Working language      English     French   Portuguese 
  
Type of stakeholder or Organisation 
Mayor or Local Authority

African small and medium size enterprises

Association of Local
      Government

 Micro-credit organization
Regional organization Workers union or pesants organization

International organization

University and research community
Association of inhabitants

Professional from central and local
      administrations
Youth organization Others (Give more precision)
Women organization
NGO

Business and Financial
      Community
   

C- Information for visa
  
Passport number
Place of issue 
Expiration date (format : JJ/MM/AAAA)
Personal address 
Zip code         
City         
Country             
 

D- Hotel 
Hotel
Address       
Phone. or Email

E- Flights
Airline company
Flight arrived 
Date 
Flight departure
Date

 Remarks
                

  
Conditions of registration
I hereby register under the terms and conditions of registration set out
  

 

International exhibition
Citexpo 2006