Registration for PA Conference 2012

Please complete all sections of this form and submit no later than 31 July 2012. Please note: ALL fields are mandatory.

First Name: Last Name: Duty Title or Appointment: NATO Rank/Equivalent: Organization: Nationality: Speaker:yes
noNational Military ID Number: Commercial Telephone: Mobile Phone: IVSN: Email Address: Social Events:Ice Breaker:yes
no Conference Dinner:yes
no Cultural Event:yes
no Dietary Requirements:Additional Remarks: