3. registration form

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2012 EASTICA Seminar & Executive Board Meeting
17(Mon) ~ 20(Fri) July, 2012
General Archival Authority, Ulaanbaatar, Mongolia
SEMINAR REGISTRATION FORM
Please typewrite and send this form by facsimile or email no later than June. 10, 2012 to:
Mrs Uyanga Bold, Foreign Relation officer of GAAM
Tel: +976-51-264846 Fax: +976-51-262351 E-mail: [email protected]
1. Participants
Title
Mr. Mrs. Prof. Dr. Other.
Name
(Given Name)
(Surname)
(Middle Name)
(Chinese characters, if any)
Nationality
Passport Number
Affiliation
Position
Country/Region
Telephone
Fax
E-mail
Work Address
Member Category
 A National/ Territorial Archives
 D Individual members
 B National/ Territorial associations of archives
 C Institutional members
 E Honorary members
 Non-members
2. Accompanying Person
Title
Mr. Mrs. Prof. Dr. Other.
Name
(Given Name)
(Surname)
Nationality
(Chinese characters, if any)
Passport Number
Work Address
3. Registration Fee
*Please mark your choice
EASTICA Members (per person)
 130$
Non- Members (per person)
 150$
 150$
Accompanying person (per person)
*Please make payment of the registration fee by cash at the registration desk of GAAM. Please contact with the GAAM if you want to pay the registration fee by
other means.
4. Participation in Program





Jul 17 (Tue)
Jul 18 (Wed)
Jul 19 (Thur)
Jul 20 (Fri)
Jul 20 (Fri)
*Please check the program in which you would like to participate and enter the number of persons to attend.
Welcome Receiption
Dinner hosted by the GAAM
Dinner hosted by the EASTICA
Visit to the new archival building
Visit to the museums
person (s)
person (s)
person (s)
person (s)
person (s)
5. Questionnaire
5-1. *Visa Application Request
Do you need our support to apply for a visa when visiting in Mongolia? (Invitation letter, etc.)
 Necessary - Nationality: _____________________
 Unnecessary


Dietary (Food) restrictions, if any: _________________________________________________________________
Other items of caution or note, if any: ______________________________________________________________
Date:_____________________
Signature: _______________________________
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