Registration Form

 

International Parliamentary Forum:

Parliamentarians,

the Nuclear Non-Proliferation Treaty and

Nuclear Weapon Free Zones

 

Parliament Buildings, Wellington, New Zealand

December 8, 2004

 

Please complete form and return to Alyn Ware alyn@pnnd.org

or fax (64) 4 385-8193

 

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Name:

 

 

Staff assistant:

Member of which parliament:

 

 

Phone number:

 

Address:

 

 

Fax number:

 

Dietary restrictions:

 

Email:

 

 

Current member of PNND:     yes/no

Arrival date (if known):

 

 

Have also registered for the ICC Assembly:

yes/no

Departure date (if known):

 Accommodation:

Novotel 4 Star Hotel

  ______ nights @ NZ$152/night (payable on arrival)