CONFERENCE REGISTRATION FORM: STEP 1

IPRA 2008 global conference
Building sustainable futures: enacting peace and development

Please note that this is how you will be indicated on your badge and the list of participants.

Date: 15-19 July 2008
Place: Leuven, Belgium

Step 1: Participant Information

1. Family Name:
2. Title: -- Prof. Dr. Mr. Ms. Mrs. Other
3. First Name:
4. Organisation:
5. Address:
6. Postal Code:
7. City:
8. Country:
9. Telephone:
10. Fax:
11. Email:
12. Have you submitted a proposal for the conference? -- Yes No
    If yes, please indicate:
    Title:
    
    Commission/working group:
13. If no, please indicate whether you need visa to travel to Belgium (please give details of your full name, passport number, date of issue and date of expiry, your address):
14. Please list any special needs:
15. If registering at the Student Rate, please provide ID Number:

Proceed to Step 2