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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: firstname.lastname@example.org 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: email@example.com 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.
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