Registration form Free entry – Registration required Registration Form for the 7th World Congress against the death penalty If you are human, leave this field blank. NB: it will still be possible to register for the Congress after 6 p.m. on 18th February 2019 but only for events taking place at Egmont Palace and Bozar. If you wish to attend the Opening Ceremony and/or the plenary session on “The Private Sector and the Death Penalty”, which will be held at the European Parliament on 27th February 2019, you must register before 6 p.m. on 18th February. Surname (as indicated on your passport) * First name * Title * Mr Mrs Title (specify) Email * Place of residence * Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Democratic People's Republic of Korea Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar (Burma) Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Palestine (State of) Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Republic of Korea Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste (East Timor) Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Yemen Zambia Zimbabwe Nationality * City Telephone no. with country dialling code Organisation Profession Languages Spoken * French English Other Do you have a permanent access badge to the European Parliament ? * Yes No Will you hold a valid Schengen visa on the Congress dates ? * Yes No Do you need special assistance (for people with disabilities) ? Yes, specify:Yes, specify: No You will receive a confirmation email soon in the form of an official invitation. This will be required for your visa application. PLEASE CHECK IF YOU NEED A VISA TO ENTER BELGIUM Travel, accommodation and other expenses remain your responsibility. By registering online to attend the Congress, you automatically renounce your image rights and agree to the use of any photos or videos of the event which might include your image being used by our partners’ networks. I want to receive ECPM’s newsletter I want to receive ECPM’s newsletter