ENUM workshop

(Geneva, 17 January 2001)

Registration form

(To be returned to the Strategic Planning & External Affairs Unit (Office T.1307 / Fax +41 22 730 5881) by)

08.01.2001

Member State/Sector Member/Organization*
*  Delete as appropriate

Mr.         Mrs.       Miss        Ms

Family name: ____________________________________________     First name: __________________________________

Official title in Administration or Organization:                                                                                                                           __________________________________________

Name and complete address of Administration or Organization:                                                                                                 __________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

E-mail:

Mobile phone:

Phone :

Fax :

Home address (optional)

__________________________________________________________________ Tel:______________________________

Hotel/Address in Geneva (see Note)

__________________________________________________________________ Tel: _____________________________

Note: Reservations must be made DIRECTLY with the hotel and not through the ITU.

Accompagnied by family member(s) - please specify                                                                                                                  __________________________________________