PARTICIPANTS REGISTRATION FORM B.pdf
International Conference Registration Form (B)
*Please read clearly and if some of these categories don't apply to you then please state by writing N/A
Name (Mr. Mrs. Miss.)
Nationality Permanent Address:
Present Address (country of resident) Phone Number:
In Case of Emergency Contact: Address:
Phone Number Fax Number
Email address:
What Languages do you speak? (In order of fluency):
Passport Number: Type of Passport:
Marital Status (circle one): Single Married Divorced Separated
Name and address of group or Organization:
Group Participation file number:
Return all registration forms along with first pages of your passport information and confirmation of your hotel booking in Dakar-Senegal to the
secretariat office via email: as soon as possible.
California Aids Foundation (C.F.A)
800 Corporate Plaza, Newport Beach, CA, 92660
Tel: +1-206-888-6737 Fax +1-516-312-4573
E-mail: registrationdesk_caf@globomail.com
PARTICIPANTS REGISTRATION FORM C.pdf
International Conference Registration Form (C)
1) Do you have relatives in the U.S.A.? Yes No (if yes, please note their address and relationship to you)
2)Describe experiences with culturally diverse situations:
PERSONAL INFORMATION
3) Religion: Do you have any dietary restrictions?
4) Do you have allergies to certain foods? (List foods)
5) Do you smoke? Yes No Can you confine your smoking? Yes No Do you have objections to others smoking? Yes No
6) If yes, briefly describe:
7) Living abroad exposes you to a lifestyle that you may not be familiar with. Will you be able to adjust to unexpected situations?
8) Hobbies and leisure time interests:
9) Have you ever been arrested or convicted of a crime? If yes, please explain:
10) How did you know of this conference?
California Aids Foundation (C.A.F)
800 Corporate Plaza, Newport Beach, CA, 92660.
Tel: +1-206-888-6737 Fax +1-516-312-4573
E-mail: registrationdesk_caf@globomail.com
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