Secretariat of the Stockholm Convention on Persistent Organic Pollutants




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Secretariat of the Stockholm Convention on Persistent Organic Pollutants

Third meeting of the Conference of the Parties (COP-3)

of the Stockholm Convention on POPs

30 April-04 May 2007, Dakar, Senegal



Registration Form for IGOs and NGOs



Please type or print clearly and do not use abbreviations.

1. Title (circle one): Ms. / Mrs. / Mr. / Dr. / Prof.

Job title: ________________________________________________________________

First Name (s): ________________________________________________________________

Surname: ________________________________________________________________

2. Full name of the Government, organization or institution that you will represent at the meeting:________

____________________________________________________________________________________

3. The above listed organization is a/an (mark an X through the appropriate box):


 United Nations organization
 intergovernmental organization other than United Nations
 non-governmental organization
 other:___________________________________________________________
4. Full mailing address:________________________________________________________________
Zip code: __________________ City: _____________________________________________
Country: ______________________________________________________________________
Tel. number, with country code: ___________________________________________
Fax number, with country code: ___________________________________________
E-mail address, where available: ___________________________________________

Please fax , mail or e-mail the completed form as soon as possible and no later than 1 March 2007 to:

A


cting Executive Secretary of the Stockholm Convention

Attention: COP-3

United Nations Environment Programme

11-13 Chemin des Anémones

CH-1219 Châtelaine, Geneva, Switzerland

Fax: +41 22 917-8098



E-mail: ssc@pops.int




Office location/Bureaux: Maison Internationale de l`Environnement, 11-13 chemin des Anémones, Châtelaine, 1219, Geneva, Switzerland


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