REGISTRATION FORM
ACI - DNA Assistance Programme
Casablanca, Morocco | 23-25 April 2015
Please fill in one registration form per participant and return it by 3 April 2015 by email to: [email protected] or
by fax (+1 514 373 1201). Warning: both pages of the registration form must be signed by the applicant and
countersigned by the airport’s Director so as to be processed. Participants are required to pay for their
plane tickets, hotel accommodation, visa if necessary, and sickness and accident insurance.
PERSONAL DETAILS
Mr.
/ Ms
/ First name: …….......…………...... Last name: ………………………......................
Business title: …………………………………………………………………........................
Airport: …………….........……………………....
Country: ………………………….....………………..
Direct tel.: …………………………………….....
Direct fax: …………………………..................
Email: ………………………………………......
Dietary Restrictions (please specify if any) : ………………………………………......
WORKSHOP INFORMATION
Which workshop would you like to attend? ***
Airport Collaborative Decision-Making Workshop (23-25 April 2015)
OR
Airport Security: Bomb Threat Identification Seminar (23-25 April 2015)
OR
Challenges of Security Training in Africa (23-24 April 2015)
(Organized in cooperation with ICAO)
***Only two (2) participants per ACI Member per workshop may participate.
Name to be printed on your certificate: ………………………………………......
ACI-DNA Assistance Programme | P.O.Box 302, 800 Rue du Square Victoria, Montreal, Quebec H4Z 1G8 Canada | Tel: + 1 514 373 1200 | Fax: + 1 514 373 1201 | Email: [email protected]
ACI Africa |Académie Internationale Mohammed VI de l’Aviation Civil, Nouasseur, Casablanca, Royaume du Maroc | Email: [email protected]
REGISTRATION FORM (continued, page 2 of 3)
ACI - DNA Assistance Programme
Casablanca, Morocco | 23-25 April 2015
TRAVEL
Arrival in Casablanca:
date: ………… time: ………
flight: ……….
Departure from Casablanca:
date: ………… time: ………
flight: ……….
Passport No:
……….……….……….
VISA
I don’t need a visa
I need a visa
If YES, please indicate which embassy or consulate the ACI-DNA Assistance Programme should address
your visa invitation letter.
(NOTE: The visa invitation letter from ACI does not guarantee that you will receive your visa)
…………………………………......................................
TERMS OF PARTICIPATION
Your registration will be reviewed and approved by the ACI-DNA Assistance Programme in conjunction
with the host ACI region.
Only 25 registrations received for each of the first two seminars and for the third seminar will be taken
into consideration on a first come, first served basis. Any registrations received beyond this number will be
placed on the seminar waiting list, to be confirmed at the discretion of the ACI-DNA Assistance
Programme.
The participation in the seminar is complementary. Participants are required to book and pay for their hotel
accommodations, their plane tickets to and from Casablanca, their visa if necessary, as well as any other
related travel expenses.
Place and date :
APPROVED by (name of Director) :
……………………………………………
………………………………………………
Applicant’s signature :
Director’s signature:
ACI-DNA Assistance Programme | P.O.Box 302, 800 Rue du Square Victoria, Montreal, Quebec H4Z 1G8 Canada | Tel: + 1 514 373 1200 | Fax: + 1 514 373 1201 | Email: [email protected]
ACI Africa |Académie Internationale Mohammed VI de l’Aviation Civil, Nouasseur, Casablanca, Royaume du Maroc | Email: [email protected]
REGISTRATION FORM (continued, page 3 of 3)
ACI - DNA Assistance Programme
Casablanca, Morocco | 23-25 April 2015
ADDITIONAL INFORMATION
Use additional blank sheets if necessary
Applicant’s education and previous professional experiences:
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………...
Applicant’s current tasks and responsibilities:
………………………………………………………………………………………………………………...
………………………………………………………………………………………………………………...
………………………………………………………………………………………………………………...
Applicant’s future career plan:
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………...
………………………………………………………………………………………………………………...
Overall objectives to be reached through the applicant’s attendance to the training seminar:
………………………………………………………………………………………………………………...
………………………………………………………………………………………………………………...
………………………………………………………………………………………………………………...
………………………………………………………………………………………………………………...
Place and date :
APPROVED by (name of Director) :
……………………………………………
………………………………………………
Applicant’s signature :
Director’s signature:
ACI-DNA Assistance Programme | P.O.Box 302, 800 Rue du Square Victoria, Montreal, Quebec H4Z 1G8 Canada | Tel: + 1 514 373 1200 | Fax: + 1 514 373 1201 | Email: [email protected]
ACI Africa |Académie Internationale Mohammed VI de l’Aviation Civil, Nouasseur, Casablanca, Royaume du Maroc | Email: [email protected]