CATA TC 2012 Reg Form 1

							                                                             (Annex I)
                          REGISTRATION FORM
                  33rd CATA ANNUAL TECHNICAL
             CONFERENCE AND 12TH GENERAL MEETING
                           FLORIANA, MALTA
                      14TH TO 19th OCTOBER 2012



                                                            **Jpeg/digital
                                                               format
N.B.: PLEASE COMPLETE IN BLOCK LETTERS                      photograph(s)




COUNTRY:
_________________________________________________

ORGANISATION:
_________________________________________________

                    DELEGATES PERSONAL DETAILS
(Dr./Mr./Mrs./Ms./Other):
Last Name:
First Name(s):
Official Designation (title):                          Head of
                                                      Delegation
                                                      Yes      No

Mailing Address:
City:
Province/State:
Postal/ZIP Code:
Country:
Tel No. Office:                      Tel No. Home:
Fax No. Office:                      Fax No. Home:
Mobile/Cellular number:
E-mail Address:
Website address:
               ACCOMPANYING SPOUSE PERSONAL DETAILS
Title (Dr./Mr./Mrs./Ms./Other):

First names:
Last Name:




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                                                                             (Annex I)
PASSPORT/CLOTHING DETAILS

Passport details                     Delegate                      Spouse
Nationality
Passport No
Date of Issue
Date of Expiry
Place of Issue
Clothing details
T-shirt size
(S/M/L/XL)


ACCOMMODATION

Accommodation during the conference will be available at the Excelsior Grand
Hotel. Various room types are available. Delegates are advised to book their
accommodation at the hotel on the attached booking form and are required to
indicate their reservation confirmation hotel below. All persons are responsible for
making their own individual hotel reservations directly with the Conference
Coordinator on the attached reservation form.

                 Hotel                   Reservation confirmation number

     Excelsior Grand Hotel

 *Other hotel (include name)


Hotel reservations at the Excelsior Grand Hotel must be made by 31st July 2012,
in order to qualify for the group rate. Reservations may be made after this date,
but are subject to room and rate availability.

Please specify if any of the following requirements is applicable to you:

Special Dietary Requirement: ___________________________________

Medical Requirement: ________________________________________

Special Cultural/Religious Consideration: _________________________


FLIGHT DETAILS

       Details                     Arrival                      Departure
Date
Estimated time
Flight number




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                                                                         (Annex I)
Please return this form duly completed on or before 30th June 2012 to the
Conference Organizing Chairman, by courier, fax or email to:

Name:          Mr. Joseph Smith

Mail:          Joseph Smith
               Inland Revenue of Department
               Beltissebh,
               Floriana
               FRN 0170
               Malta

Tel.:          +356 2296 2722

Fax:           +356 2296 2806

Email:         joseph.smith@gov.mt

A copy of the registration form must also be sent by e-mail, fax, or by post
to the CATA Secretariat in London, United Kingdom at one of the following:

Mail:          CATA Secretariat
               c/o Commonwealth Secretariat
               Pall Mall
               London
               SW1Y 5HX
               United Kingdom

Tel.:          +44 020 7747 6473/4

Fax:           +44 020 7747 6225

Email:         cata@commonwealth.int




        Signature of CATA Country                  OFFICIAL STAMP
             Representative

   (Not applicable to special guests)




Signature of delegate       ________________________

Date:                       ________________________

*Transport will not be provided for delegates making reservations at any hotel
other than the Excelsior Grand Hotel

**It is recommended that delegates and spouses photographs be in jpeg or digital
format. These may be sent separately indicting the name of the delegate/spouse
and their country/organization




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