Inscrivez-vous � la troisi�me session du Forum urbain mondial

Les champs marqu�s d'un * sont obligatoires

Donn�es personnelles
Titre *	>>> Choisir Dr. Ing. H.E. Hon. Lic. Maire M. Mme. Mlle. Prof. R�v. Sr.
Pr�nom *
Nom de famille *
Sexe *	F�minin Masculin
Donn�es organisationnelles
Nom de l'organisation
D�partement
Titre
Type de partenaire *	Gouvernement Secteur priv� Institut de recherche Organisation intergouvernementale Autorit� locale Fondation M�dia ONG Nations unies Parlementaires
R�SERV� aux repr�sentants gouvernementaux : indiquez le gouvernement que vous repr�sentez.	>>> Choisir Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Democratic People's Republic of Korea Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao, China Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia (Federated States of) Monaco Mongolia Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Zealand Nicaragua Niger Nigeria Niue Norway Oman Pakistan Palau Palestinian National Authority (PNA) Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Republic of Korea Republic of Moldova Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syrian Arab Republic Tajikistan Thailand The former Yugoslav Republic of Macedonia Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Taiwan Uganda Ukraine United Arab Emirates United Kingdom Of Great Britain and Northern Ireland United Republic of Tanzania United States Of America Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Yemen Serbia and Montenegro Zambia Zimbabwe
R�le principal au FUM3 *	Participant Exposant Secr�tariat Conf�rencier invit�
Forfait de stands (r�serv� aux exposants)	Option A, 1 980$ - 400 pi/36 m Option B, 999$ - 200 pi/18 m Option C, 495$ - 100 pi/9 m Option D, 32,80 $/m Stand brut (r�serv� aux stands de 400 pi/36 m et plus)
Coordonn�es
Adresse (ligne 1)*
Adresse (ligne 2)
Ville/communaut�*
Code postal/ZIP
�tat
Pays*	>>> Choisir Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Democratic People's Republic of Korea Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao, China Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia (Federated States of) Monaco Mongolia Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Zealand Nicaragua Niger Nigeria Niue Norway Oman Pakistan Palau Palestinian National Authority (PNA) Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Republic of Korea Republic of Moldova Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syrian Arab Republic Tajikistan Thailand The former Yugoslav Republic of Macedonia Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Taiwan Uganda Ukraine United Arab Emirates United Kingdom Of Great Britain and Northern Ireland United Republic of Tanzania United States Of America Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Yemen Serbia and Montenegro Zambia Zimbabwe
Courriel*
T�l�phone (inclure indicatif r�gional - pays et ville)*
T�l�phone portable (inclure indicatif de pays)
Fax (inclure indicatif r�gional - pays et ville)
Donn�es pour le Forum
Date d'arriv�e
Date de d�part
Langue de travail*	>>> Choisir Anglais Français
Nous autorisez-vous � partager vos donn�es d'inscription avec nos partenaires?*	>>> Choisir Oui Non
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