The 5Th IUCN Asia Regional Conservation Forum

GREENING ASIA’S GROWTH Nature +

The 5th IUCN Asia Regional Conservation Forum 27-30 September 2011, Incheon, Republic of Korea

REGISTRATION FORM

Please complete this registration form and return by email no later than 30 June 2011 to;

IUCN Asia Regional Conservation Forum Tel: + 66 2 662-4029 63 Sukhumvit Soi 39 Fax: + 66 2 662 4387 Bangkok 10110 Email: [email protected] Thailand www.iucn.org/asia

1. PARTICIPANT INFORMATION:

Prefix Mr  Ms  Dr  Professor  Family Name Other names Gender Male  Female  Designation Organization Category  IUCN Member  Conservationist  IUCN Councillor  Scientist/Educationalist  Commission Member  Media  Partner  Private Sector  Accompanying Person  IUCN Staff  International Organisation  Other: Please Specify ______Postal Address City Country Telephone Cell Facsimile email Website 2. PERSONAL INFORMATION

Name (as shown in Passport) Nationality Passport Number Date & Place of Issue Date of Expiry

3. TRAVEL INFORMATION

Flight details Date and time of Arrival Date and time of Departure Visa Assistance YES  NO  Required? Will you be accompanied by YES  NO  anyone? * If yes, state name(s) and other relevant details:

4. HOTEL ACCOMMODATION

*Single room 

Double room 

 I wish to share the room with ………………………………………………. Twin sharing   I have no choice

Smoking room  Non-smoking room 

*In case any sponsored participant is interested in single rooms, she/he will need to bear the difference in cost between a single and 50% of a twin shared room

RCF information and updates are available on the IUCN website at: http://www.iucn.org/about/union/secretariat/offices/asia/asia_regional_conservation_forum_2011/ 5. MEAL PREFERENCE

Halal  Vegetarian  Any other (Specify)  None 

6. EVENT ATTENDANCE

Which thematic  a. Sharing nature’s benefits fairly and equitably including due concurrent plenary consideration to gender equity for sustainable development in Asia session/s would you like to attend?  b. Nature based solutions to address climate change impacts in Asia (please select a. or b. in each case)  a. Managing ecosystems to improve food security for Asia’s poor

 b. Greening Asia’s economic growth for sustainable development and poverty reduction

Do you plan to  attend the Eco-tour* on September 30?

* Details to be provided

7. PARTICIPATION COST *

I will pay for my expenses  I am an IUCN-sponsored delegate 

* IUCN will cover the cost of registration for the sponsored IUCN members and IUCN staff. A registration fee of US $ 100, will be changed to all other participants.

RCF information and updates are available on the IUCN website at: http://www.iucn.org/about/union/secretariat/offices/asia/asia_regional_conservation_forum_2011/