SECURITY FORM
2013 UNCTAD Public Symposium
24–25 June 2013, Geneva
Please bring this completed form with you along with a valid passport or national identification card to
complete security procedures and be issued a badge at the Pregny Gate Entrance of the Palais des
Nations in Geneva. Please arrive at least 1.5 hours before the event to allow for entry processing to the
United Nations.
1. Are you in possession of a UNOG Grounds Pass?
Yes
No
2. Personal Information
Mr.
Last (Family) Name:
First Name:
Date of Birth (DD/MM/YY):
Ms.
Name of Organization:
Official Title/Position:
Work Telephone:
Personal Telephone:
Fax:
+
+
+
Address:
Email Address:
Website:
Type of Institution:
Member State
Private sector
Non-governmental/civil society organization
Parliamentarian
Academia/university-affiliated
International organization (United Nations organization/specialized agency)
Media
Other (please specify):
Intergovernmental organization
3. Identification Details
Passport or ID Number:
Issuing Authority/Country:
Valid until (DD/MM/YY):
Address in Geneva:
Date of Arrival in Geneva (DD/MM/YY):
Date of Departure from Geneva (DD/MM/YY):
4. Upon Issue of Badge:
_________________________________
________________________
Signature
Date
IMPORTANT: For security reasons, upon arrival at the United Nations Office, Geneva, you will be required to
present your passport or official identity card.
OFFICIAL USE ONLY:
Date registered
Card Type
ID Number
Issued by
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