Observer Registration Form
Midterm Elections in the United States,
4 November 2014
Registration Date:
(dd.mm.yy)
PERSONAL INFORMATION
(Please answer each section clearly)
Family Name:
First Name:
Nationality:
Passport Number:
Date of Birth:
(dd.mm.yy)
Mobile in the field:
(country code +number)
Email:
Passport Type:
Diplomatic/Regular/Service
CONTACT PERSON
(Indicate contact details for the person in charge of practical arrangements for your participation)
First Name &Surname
:
Mobile:
Email:
TRAVEL INFORMATION
Arrival Date:
(dd.mm.yy)
Arrival Time:
(hh:mm)
Arrival Flight:
Departure Date
:
(dd.mm.yy)
Departure Time:
(hh:mm)
Departure Flight:
DEPLOYMENT ON ELECTION DAY
As this is a limited mission we will only deploy in the vicinity of Washington, DC and neighbouring
areas, primarily in co-operation with the International Foundation for Electoral Systems.
IFES programme / tour of polling places (recommended):
Embassy-supported transportation and interpretation:
Please return this form together with a passport copy by
Friday 3 October 2014
to
the OSCE PA International Secretariat tel: +45 33 37 80 40 fax +45 33 37 80 30,
OSCE PA
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