Registration Form of Global Dialogue 2009
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Politics and Justice without borders
The theme of Global Dialogue 2009 is:
Global Community
Global Movement to Help
offers
Essential Services

to serve the people of all nations, all life on Earth


Participants to the Global Dialogue 2009 must register. There are no registration fees. One registration per form. Register by email at: globalcommunity@telus.net You may also register by post office mail. See postal address below.

Participants submitting research papers to the Global Dialogue 2009 must submit the Paper Submission Cover Sheet. If there are more than one authors please list them all in the message area. Send an email message if needed. If you have a long abstract please send it by email. If you wish to communicate with Global Dialogue 2009 please send us a message using the contact information below.




Ms. Mr. Mrs. Dr.
First name: ________________________________________ Last Name: _____________________________

__________________________________________________________________________________________

Title/Position: ______________________________________ Department: ____________________________

Organization: ______________________________________________________________________________

Address (street number and name):
__________________________________________________________________________________

City: ____________________________________________________________

Province/Territory: _________________________________________________

Country: _________________________________________________________

Postal Code: _____________________________________________________

Telephone: _______________________________ ext: _______________ Fax: ________________________

E-mail: __________________________________________________
Website: _________________________________________________

Sector:
 Federal Government  Provincial Government  Municipal Government
 Corporate  Academic  NGO  Media  Student
 Other (please specify): ____________________________________________________________________
Are you making a presentation? Yes No
If yes, title of presentation:_________________________________________________
Short summary: _________________________________________________
____________________________________________________________________
____________________________________________________________________
Are you organizing a Workshop Session in your community? Yes No
____________________________________________________________________
If yes, do you need help other than monetary help? Contact us if needed.
Describe your Worksho Session (goal, issue(s), place, participants, day and time, results, recommendations, etc.):
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Do you wish to participate in a Discussion Roundtable on Internet? Yes No
What issue(s)?
____________________________________________________________________
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