4 Registration form SPIA 2013 .pdf


Nom original: 4 - Registration form SPIA - 2013.pdfAuteur: ADILE

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AISP
Association Internationale

SPIA
Soldiers of Peace

des Soldats de la Paix

International Association

REGISTRATION FORM
Please, fill this form and return before May 10th 2011, to: S.P.I.A.
178 rue Garibaldi 69003 Lyon, France.
Additionally, please send a copy of your ID card or your passport.
For security purposes, you must present your original ID when entering the United
Nations.
Upon reception of your registration form, we will send you the United Nations registration
form which grants access to visitors to the Geneva Palais des Nations.
Last
Name :
ID # :
¤ Passport
¤ ID Card

First
Name :
Issue date:

- - /- - /- -

Expiration
date :

- - /- - /- -

Date of birth - - /- - /- at……………………………

Nationality (ies) :
E-mail :

Phone # :

¤ I will participate to the Peacekeepers International Day in
Geneva on May 30th *

Signature

I would like to use the Lyon/Geneva bus round-trip travel
provided by SPIA
¤
Fees: 30€ (20€ for the
¤ Yes
transport fees and 10€ for the
application fee)
¤
Fees: 10€ for the
¤ No
application fee
¤ I will meet the group at the Palais des Nations in Geneva at 9 a.m. at the principal entrance:
PORTAIL DE PREGNY, 14 Avenue de la Paix (see UN map attached)
¤ I will meet the group at the Quartier Général-Frère in Lyon’s 7th district for a departure
scheduled at 7:00 a.m. at 22 Avenue Leclerc 69007 Lyon (entrance on the Rhone side).
¤ I would like to be decorated with the Nobel Peace Prize medal (77€ the set)
¤ I would like to be decorated with the Peace Commemoration medal (55€ the set)
PURCHASE UNDER CONDITIONS: Please contact the A.M.E. for an order form:
medailles@fname.info - phone : 33 4 78 95 45 03
I would like SPIA to book a hotel room
¤ Yes
For …….. people
Arrival on :
…/05/2013 at …..h……
Departure on : …../…../2013
Transport mode : ¤ Car
¤ Train

¤ No

¤ Air plane

¤ in Lyon

¤ in Geneva

Soldiers of Peace International Association
178, rue Garibaldi - 69003 LYON – FRANCE
Tél 33.(0)4.78.95.45.03
Internet: http://www.aisp.fr – Email : direction@aisp.fr

AISP
Association Internationale
des Soldats de la Paix

SPIA
Soldiers of Peace
International Association

* We reserve the right to refuse any registration.

Soldiers of Peace International Association
178, rue Garibaldi - 69003 LYON – FRANCE
Tél 33.(0)4.78.95.45.03
Internet: http://www.aisp.fr – Email : direction@aisp.fr


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