registration_form_sotoudeh

							                        Registration Form
                                 Insight Dubai Conference
                                  27th – 31st March, 2011

Please complete the following details and send it back to Haya Al Mutlaq on
E-mail: haya.almutlaq@hct.ac.ae Fax: +9714-2673939

Applicant’s Details

Applicant’s Name:            Nazpari Sotoudeh

Date of Birth:               June 19th, 1992

                                      Nazpari Sotoudeh
Address:
                             1 CHAPIN WAY BOX NO 8143 SMITH COLLEGE
                             NORTHAMPTON, MASSACHUSETTS 01063-6302
                             United States




                                 1 CHAPIN WAY BOX NO 8143 SMITH
City/State/Prov/Zip Code:   NORTHAMPTON, MASSACHUSETTS 01063-6302
                                  COLLEGE
                                 NORTHAMPTON, MASSACHUSETTS 01063-
Country of Residence:       USA 6302
                                 United States

Country of Origin:          Iran Phone: 203-451-6309

                             203-451-6309
Telephone Number:

Fax:                         -

E-mail Address:              nsotoude@smith.edu

                             2011
Program/Year:

Write briefly about your Educational Background:
 I am a dual citizen of Iran and Dubai. I went to public school in the USA until I
 was 8, then attended primary and secondary schools in Dubai. I also attended
 Tehran International School in Iran for 6 months. In 2005, I began a
 homeschooling program, and in 2008 I transferred to the Hotchkiss School in the
 USA where I graduated from in 2010. I am now a first-year student at Smith
 College.
Explain why you decided to participate at the Insight Dubai Conference?
 As a Middle Eastern citizen and a member of a women’s college, I am highly
 affected by gender and global issues. When I learned about this conference, I
 became immediately interested in its motives and felt that I could make a good
 contribution to it with my interests and experiences.

Have you participated in conferences before? Please specify.
 No.

What do you hope to achieve by attending this conference?

 By participating in the conference, I hope I can gain leadership skills and learn
 how to make a change in the world. The conference will give me an opportunity to
 participate and facilitate dialogue with others and to meet inspiring and intelligent
 women from around the world. I hope that I can learn from others and that others
 can learn from me.

Can you specify the source of your sponsorship e.g. personal, university, college,
educational institute or humanitarian organization?

 Smith College

Where have you heard of the conference?
 I learned about the conference from the
Do you have any health problems that need special attention or requirements?
 No.
Name & Contact of a person in case of an emergency
 Nazgol Saati

 425 East 58th st. Apt 4E
 New York, NY 10022
 1-917-373-5029




Details of applicant’s Educational Institute

Name of Educational Institute:      Smith College

Address:                            Northampton, Massachusetts 01063
Country:                           USA


Telephone Number:
                                  413-584-2700


Fax:



Email:



Name of the Coordinating Staff:


Position:

E-Mail:

Direct Telephone Number:           413-584-2700



Fax:


Details of Conference Fees

There will be registration fee of US$850 which includes:
    6 nights accommodation
    All meals
    Transportation
    Visa if required
    Conference fees
    Special Events and field trips

The students can do the payment through a Bank transfer to the following address and
once it’s sent please scan and e-mail the transfer document.
      Account # 1012022866101
      Account name: Dubai Women’s College- Associated Students Fund
      UAE Swift Code: EBILAEAD
      Emirates NBD
      Rashidiya Branch, Dubai, UAE
      P O Box 777, Dubai, UAE
      Tel: +9714 2222111
      Fax: +9714 2216655

Transportation and Hotel Services

    Transfers from the airport will be provided by the college.
    All meals and social activities will be covered by the conference fee that you will
     pay earlier. Students will not require extra cash, just personal pocket money.
    Participants of Insight Dubai will stay in an Apartment Hotel which is located just
     5 minutes from Dubai Women's College and 15 minutes from the airport. You
     will be rooming with girls from other countries determined by the organizing
     committee for a truly multicultural experience. If you need to stay for extra nights
     you will need to pay it on your own and you must inform the Conference
     Manager to do the reservation.
Visa Application

All Participants will require Entry Visa before traveling to Dubai, except travelers with
passports from the following countries listed below DO NOT REQUIRE VISAS TO
ENTER DUBAI, Entry visa will be issued at Dubai Airport.

Austria               Hong Kong               New Zealand
Andorra               Iceland                 Portugal
Australia             Italy                   Switzerland
Belgium               Ireland                 Sweden
Brunei                Japan                   Spain
Cyprus                Liechtenstein           San Marino
Canada                Luxembourg              Singapore
Denmark               Malta                   US
France                Monaco                  UK
Finland               Malaysia                Vatican
Germany               Netherland
Greece                Norway

Requirements for applying to get the entry Visa are as follows:
   1. Clear passport copy with a validity of not less than 6 months.
   2. Clear personal picture.
   3. Both parents first name
   4. Father’s Profession
   5. Address in home country

Special Notes:
   1) Entry permits are valid for 60 days from the date of issue.
   2) Travelers with Middle East passports (NOT GCC) and travelers with European
       Passports having Muslim names will go through a security check to issue their
       Entry Visa. Therefore, please request all concerned participants to forward their
       information in advance to process the paper work – (Security process takes
       minimum 7 working days).
   3) Special permission is required for Nigeria, Niger and Bangladesh passports
       holders.
   4) Travelers on Pakistan Airways or Air Blue must send their Flight Itinerary to us to
       obtain (OK to Board) stamp from the airline in Dubai or you will not be allowed
       to board to the aircraft.