United Nations-Nations Unies

Division for Sustainable Development. Department of Economic and Social Affairs (DESA). United Nations Secretariat Building, 405 East 42nd Street, New York, NY 10017, USA. United Nations stHigh-level Political Forum on Sustainable Development - (HLPF 2016). th (21 - 24 June, 2016 @ QEII Centre, London - United Kingdom.).

Conference Registration Form (Print this form and fill completely) PERSONAL INFORMATION Name(s): (Dr. Mr. Mrs. Miss) ______________________________________________________________________________ Organization: ___________________________________________________________________________________________ Address 1: _____________________________________________________________________________________________ Address 2: _____________________________________________________________________________________________ E-mail: ________________________________________________________________________________________________ Telephone / Fax: ________________________________________________________________________________________ City: __________________________________________________________________________________________________ State/Province: _________________________________________________________________________________________ Zip/Postal Code: ________________________________________________________________________________________ Country of Origin: _______________________________________________________________________________________ TRAVEL INFORMATION Date of Birth: _________________________________ Place of Birth: _____________________________________________ Passport Type: _____________________________Age: ________________ Sex: ____________________________________ Marital Status: (Single, Married, Divorced) ___________________________________________________________________ Passport Number: _______________________________________________________________________________________ What Language Do You Speak? _____________________________________________________________________________ VISA INFORMATION (Would You Need a Visa to London? Please Indicate): (Yes/No)

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United Nations-Nations Unies

Jun 24, 2016 - United Nations Secretariat Building,. 405 East 42nd Street, New York, NY 10017, USA. United Nations High-level Political Forum on Sustainable Development - (HLPF 2016). (21st - 24th June ... to the United Nations. All information collected on this form is used for conference registration purpose only.

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