COP17 Side Event Registration Form

Organisation Details

Name of Organization: *

Organisation Description: *

Address of Organisation: *

Organisation Telephone Number: *

Organisation Fax Number:

Organisation Website:

Applicant Details

Applicant's First Name: *

Applicant’s Last Name: *

Applicant's Position in the Organisation: *

Applicant's Telephone Number: *

Applicant's Mobile Number: *

Applicant's Fax Number:

Applicant's E-mail: *

Side Event Application Details

Brief description of the type of event you intend to host (max 200 words): *

Topic of the side event: *

Linkage to COP17: *

Number of days/hours required for the side event: *

Number of expected participants: *

Resources required: *

Additional Information:

Resources