Registration form

Armenia-Georgia Territorial Cooperation Programme
Final Conference
June, 16 2017

Please fill in the registration form by June 5, 2017!
Please kindly note that all fiels are mandatory to fill in. After sending the registration form you will receive confirmation of participation in the conference. In case you have not received a confirmation letter by June 7, 2017, please contact the secretariat of the conference: Mr. Avetik Simonyan, , tel.: +374 93 03 08 71


* Participant

Last Name (in English)

First Name (in English)

Company/Institution (in English)

Position (in English)

Mrs/Mr

Last Name (in Russian)

First Name (in Russian)

Company/Institution (in Russian)

Position (in Russian)

* Country/Region
Georgia
Samtskhe-Javakheti
Kvemo Kartli
Armenia
Shirak
Lori
Tavush

Other:

* Contact information

City with postcode (in English)

Address (in English)

Phone (with international codes)

E-mail

City (in Russian)

Address (in Russian)

* Sector you work in
State Actor
Non-state actor
Donor Organisation
EU Institution
Mass-media

Other:

* Please indicate the need for the transfer and corresponding departure/arrival point
Georgia
Akhaltsikhe (Samtskhe-Javakheti)
Rustavi (Kvemo Kartli)
Tbilisi
No need
Armenia
Vanadzor (Lori)
Ijevan (Tavush)
Yerevan
No need
* Please indicate the need for accommodation in Gyumri
1 night (June 15-16, 2017)
1 night (June 16-17, 2017)
2 nights (June 15 -17, 2017)
No need
Submit