Registration Form PICP Conference
38th Pacific Islands Chiefs of Police (PICP) Conference
Hosted by the Royal Papua New Guinea Constabulary
in Port Moresby, Papua New Guinea
1 – 3 SEPTEMBER 2009
REGISTRATION FORM
Please complete and return this form as soon as possible to the PICP Secretariat .
Delegate’s Name:
(First Name) (Family Name) (Preferred Name)
Designation/Rank:
Country/State:
Observer Organisation:
Name of accompanying person(s) including partners:
__________________________________________________________________________________
- __________________________________________________________________________________
(First Name) (Family Name) (Preferred Name)
Accommodation Requirements:
Date of Arrival: ___________ Date of Departure: _____________________
Special dietary/medical/religious or other needs:______ ________________________________________
_________________________________________________________________________________________
TRAVEL FUND
Do you wish to be part of the PICP Travel Fund: Yes or No
OFFICE CONTACT for further correspondence & communication:
Contact:_________________________________________________________________________________
Phone/Fax/Email:
Travel Details (if already known, otherwise leave flight number only blank)
Arrival in Port Moresby, Papua New Guinea
Date: ____________ Time:_________________ Flight #:_______________
Departure From Port Moresby, Papua New Guinea
Date: ______________ Time:_____________________ Flight#:____________
Please attach with your registration, scanned or copied extracts from your passports, that show the following information, this is required for all persons mentioned on this form.
- Full name
- Passport Number
- Nationality of Passport & citizenship
- Date of Birth
- Issue date of passport
- Expiry date of passport
- Where the passport was issued
Please return this form by 3 July 2009 to:
Dave Potaka
Inspector- Deputy Director
Pacific Islands Chiefs of Police (PICP)
180 Molesworth Street
PO Box 3017
Wellington, New Zealand
Fax: 64-4-470- 7103 or via Email: dave.potaka@police.govt.nz or picp@police.govt.nz
