"European Blind Union"
European Blind Union Women´s Conference ´Making the UN convention work for visually impaired women´ 26-28 March 2010 - Larnaca, Cyprus REGISTRATION FORM Please remember to include the questionnaire on the UN convention with your registration! Please register before March 8th by returning this form by email to the address mentioned below, or online: www.cyprusblindwomen.com/conference 1. PERSONAL DETAILS Country: Full Name of participant (last name in capital letters please): Mrs/ms Member of the EBU women´s network: yes/no Are you blind or partially sighted? Are you active in your national organisation? No/yes If yes, what is your position? Do you have a paid job in your organisation? Yes/No Do you have a paid job outside your organisation? Yes/No What are specific areas of interest to you? In what area do you have expertise? EBU member organisation name: 2. CONTACT DETAILS E-mail Address: Telephone number: Cell phone number: Skype: 3. GUIDES/INTERPRETERS Will you be travelling with a guide or interpreter? Yes/No Full name of guide/interpreter (last name in capital letters pleas): Mr/mrs Please note that language used in the conference will be English. 4. Guide dogs Will you be travelling with a guide dog? Yes/no 5. Visa Do you require a Visa to enter Cyprus? Yes/No 6. TRAVEL DETAILS Date of Arrival: Time of arrival in Cyprus: Flight number: Flying in from: Date of Departure: Time of departure from International Airport Larnaca: Flight number: Flight destination: 7. ACCOMODATION Number of single rooms: Number of double rooms: 8. Will you participate in the excursion offered by POB on Sunday afternoon? YES/NO 9. Share your talents! ART AND CULTURAL PROGRAMME Do bring an art piece (or more) or give a short performance (music, song, dance, poems, etc). The art show and cultural event will take place on Friday 26th of March. Fill out the info below and participate! Yes, I will contribute to the cultural evening with: - Performance of (song, dance, music, poetry reading, etc): - Artwork (type of artwork, size, number of pieces): - Please give as much information as possible 10. QUESTIONNAIRE ON UN CONVENTION Your collaboration is needed for this EBU women´s conference in Cyprus: Have you attached the filled out questionnaire on the UN Convention that you received with the invitation letter and this registration form? Yes/NO If not, please do fill it out asp and email it to the POB before March 12th You can also fill it out and register online: www.cyprusblindwomen.com/conference The Pancyprian Organization of the Blind Christakis Nicolaides Tel.: +357 99 65 74 67 Fax: +357 22 49 53 95 E-Mail: firstname.lastname@example.org Maria Kyriacou Tel.: +357 99 57 13 23 email@example.com