Family Name* (required):
First Name* (required) :
Title * (required) :	H.E.  Prof.  Dr.   Mrs.   Ms.  Mr.
Name of Delegation * ( Government, Institution, Company, NGO, Media, etc.. required):
Position in the Delegation (required) :	Head of Delegation Member   Adviser   Observer   Other
Category of Delegation * (required) :	Intergovernmental Organization   Government   National agency or entity   Local authority or agency   NGO or Civil Society   Academia or Research   General Business   Technical Internet Entity   Lawyer   Independant Consultant   Press   Blog   Other
Address* (opt.) :
City* (required):
ZIP code* (opt.):
Country* (required):
Private Phone ( opt., for possible contact for the event by the organizers) :
Public Phone * (opt.) :
Fax * (opt.) :
private email (required for registration confirmation and further posts, kept private) :
public email * ( opt.) :
Web Site * (eg. www.example.net opt.) :
Participation to the Workshop (required) :	YES Not sure NO, but keep me posted for next conferences on the topic NO

Comments & Suggestions ( private, opt.) :

* Public information

The list of registered participants, including only public information *, will be sent by email after the meeting, to all registered participants who effectively retrieved their badges.