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Registration Form |
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Download the Registration Form in
DOC
or
PDF
format or
(Print this Registration Form and Fax it at this
Number)
GLOBAL
SYMPOSIUM: ‘Awakening Planetary
Consciousness’
from 7 to 10 December 2007, Lucknow, INDIA
Form A:
REGISTRATION FORM
There is no fee for
registration. All you need to do is to fill this
form and send to us. As soon as the Organizing
Committee approves your participation, we will
inform you.
Kindly note:
You can participate in Global
Symposium either as a participant or a presenter
or workshop leader. You can highlight the option
that you choose below:
Yes, I would like to
participate in the Global Symposium 2007 as
Participant (Required to fill Form A
i.e. page 1 only)
Presenter or Workshop Leader (Required to
fill both Form A & Form - B i.e. both pages 1
& 2)
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Title (Mr, Ms, Dr,
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Name: |
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Designation: |
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Organization: |
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Address:
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Country: |
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Name of Accompanying
Person/s: |
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Tel (Incl.
International Dialling Code): |
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Fax (Incl.
International Dialling Code): |
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E-mail: |
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N.B.: If you require
assistance for obtaining a visa, please
contact the Global Symposium 2007 team
at the Secretariat, World Movement for
Global Democracy (WMGD), CMS, Lucknow
(Email:
symposium@wmgd.net
Tel:
+91 9450 502 259) |
Passport Details (If
available, please fill below. This is required
for visa-invitation purpose):
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Name as in Passport: |
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Passport No.: |
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Date of Birth: |
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Date of Issue: |
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Date of Expiry: |
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Place of Issue: |
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City in your country
where you will apply for visa: |
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Please note:
1. Participant
need to send us only first Page (Form - A) only.
Kindly send it along with yourbiography (250-500
words) and latest photograph as attachment.
2. Presenter or Workshop Leader are
required to send us both pages (Form - A & Form
- B) duly filled along with the attachments
mentioned in the Guidelines of Page 2 (Form -
B).
Kindly return this form
before 15 November 2007 to:
By mail:
Mr Shishir
Srivastava
Organizing Secretary, Global Symposium and
Secretary General, World Movement for Global
Democracy (WMGD)
C/o City Montessori
School (CMS)
12 Station Road, Lucknow (U.P.) – 226 001 INDIA
By fax:
+ 91 522 2638
008/ +91 522 2635 497
By email: symposium@wmgd.net
Form B: Proposal for Presentation/
Workshop
I would like to
propose:
Workshop
Presentation
Both
(You may choose
to present either one or both and send your
proposal accordingly)
Name:
Country:
Email:
Guidelines for Presenter or Workshop Leader
To actively participate at the Global Symposium
2007, you must download the
Registration
Form (Form A) and send it to us by email
or fax.
The
below mentioned items can be subsequently sent:
1. Your Presentation
/ Workshop Proposal on the themes of Global
Symposium in a word file.
For
Paper Presentation (duration: 20 minutes)
The
Presentation should not exceed 20 minutes. It
should have title and a brief introduction of
250 to 300 words. You can bring your
presentation in a CD. All Conference Rooms are
well equipped with computers, projectors and
screens.
For Workshop (duration: 75 minutes)
The
duration of workshop is limited to 90 minutes
and includes a 15 minute question - answer
session. It should have title and a brief
introduction of 250 to 300 words. You can bring
your presentation in a CD. All Conference Rooms
are well equipped with computers, projectors and
screens. You may send your proposal for both
presentation and workshops. However, we will
decide according to the space available in the
programme and will inform you accordingly.
Choose your theme from the proposed themes given
at
www.wmgd.net/symposium
2. Your Brief Biography:
(about 250 - 500 words, describing about your
work and the organization that you represent).
You may send us your complete CV as well.
3.
Your Photograph:
digital
or scanned photo in JPEG or TIFF format.
Please note:
1) Your application for Presenter or Workshop
Leader will be considered as complete only when
we receive it with the above items.
2) Please send all the
above documents on or before 15th
November 2007 to:
By mail:
Mr Shishir Srivastava
Organizing Secretary, Global Symposium and
Secretary General, World Movement for Global
Democracy (WMGD)
C/o City Montessori
School (CMS)
12 Station Road, Lucknow (U.P.) – 226 001 INDIA
By fax:
+ 91 522 2638 008/ +91 522 2635 497
By email: symposium@wmgd.net
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