STUDY TOUR ON "The role of religious communities in social work" ORGANISED BY THE PEOPLE 2 PEOPLE PROGRAMME REF: P2P 32350 PLACE & DATE: BRUSSELS, 20-23 SEPTEMBER 2011 Instructions to participants: 1) Read this form carefully and complete both pages in typewritten and title case letters only. Please do not use all lowercase or uppercase (for example, type Veterinary Inspector, not VETERINARY INSPECTOR or veterinary inspector). 2) Please quote the five-digit event reference above in all communications. PARTICIPATION FORM Country: Mr Ms First name: Surname/Family name: (as on your passport) Organisation: Function/Position: Office address: Post code: City: Office Tel: Office Fax: Mobile Tel: E-mail: Passport number1: Date of birth1: 1 We kindly ask you for this information as it has to be given to the security staff at the meeting venue. I would like to travel by: PLANE TRAIN (SELECT ONE) Airport of Departure: Please indicate if you use a wheelchair or any specific equipment that should be noticed to the airline: I would like GTZ to book a hotel room: YES NO Please note that if you do not answer GTZ will not book a hotel room. Please indicate if you need a room adapted to people with physical disabilities: YES NO Will you need to apply for a Schengen visa? YES NO If yes, please note that the European Commission will provide you with an official invitation letter that may be needed for obtaining your visa. However, you will be fully responsible for obtaining your visa in due time. I agree to share my contact details with the other participants for the purpose of this workshop (country, name, organisation, complete office address, phone and fax numbers, e-mail address): YES NO Data Protection: Personal data contained in this document will be processed in accordance with the privacy statement of the TAIEX instrument (see http://taiex.ec.europa.eu/PrivacyStatement) and in compliance with the Regulation (EC) N°45/2001. Evaluation of P2P Events With the view to strengthening our services, we will invite you to complete an evaluation form after the event has taken place. Questions refer to the logistical arrangements, the overall quality of the event and/or the contribution of experts.