Registration Form for Media

Note: Journalists who would like to attend the Conference of African Ministers, which will be held from 18 to 22 May 2004; please put your details on Section I below. Those journalists who can not attend the conference but need information and documents on the conference, or those who need telephone interview with participants or delegates, please put your details on Section II below.

Section I

Applicant’s details

Name of Organization/Institution:
Name/Surname (Mr./Ms.):
Nationality:
Passport number:
Press card number:
Position/Title:
Address:
City/Country:
Telephone:
Cell Phone:
Fax:
E-mail:
Do you need visa? Yes No
If yes, do you want an invitation letter? Yes No
   
Equipment (Give make and serial number)
Camera:
Computer:
Tape Recorder:
Other (Please specify):
   
Itinerary  
Arrival Date/Time:
Via:
Airline:
Fight number:
Departure Date/Time:
Destination:
Via:
Airline:
Flight number:

  

   

Section II

Name of Organization/Institution:
Name/Surname (Mr./Ms.):
Position/Title:
Address:
Post/zip code:
City/Country:
Telephone:
Cell Phone:
Fax:
E-mail:
1) Do you want to receive documents via e-mail or your postal address?
Via e-mail through my address
2) What kind of documents do you want to receive?
Press Releases Conference Documents All
3) Would you like to have Telephone Interview with participants/delegates etc.?
Yes No
4) Special Needs, Please specify.