Invitation Letter

ANNEX 2 Regional seminar on the implementation of the 2012 Cape Town Agreement for CIS and Eastern Europe region Saint Petersburg, Russian Federation, 8 to 11 December 2015 NOMINATION FORM FOR PARTICIPATION A completed nomination form, including the acceptance form, should be received by the International Maritime Organization (IMO) not later than Friday, 13 November 2015. Please use a separate form for each nomination, indicating clearly the nominating authority’s priority if more than two participants are nominated. Nominations arriving after this deadline might not be considered. 1 _________________________ ____________________ ________________ FAMILY NAME FIRST NAME OTHER NAME 2 Organization _________________________________________________________________ Title/Position in your organization _________________________________________________ Official mailing address _________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Telephone: _________________________ Fax: _____________________ Work Email: ______________________________ Home Email: ______________________ Mobile: _______________________ 3 Date of birth ____________ 4 Sex Male _____ Female ____ 5 Place of birth ______________ 6 Nationality ________________ 7 Passport Number_____________ 8 Date and Place of Issue ______________________________ 9 Person to notify in case of emergency Name ______________________________________________________________________ Address _____________________________________________________________________ ____________________________________________________________________________ Telephone: _________________________ Fax: _____________________ Email: ______________________________ Mobile: ______________________ 10 Description of your duties _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ 11 Educational background _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ 12 Previous experience ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 13 Previous relevant meetings attended _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ 14 If a certificate is to be issued, please print clearly the name as it should appear on the certificate. _____________________________________________________________________________ ______________________ Nominee's signature Please tick the box to confirm that the nominee meets the profile required for this meeting and is the most appropriate candidate. Each nomination should be submitted in full to: ______________________________ Mr Ivaylo Valev Signature of Government official Head, CIS and Eastern Europe Section, authenticating this nomination Technical Cooperation Division, IMO Tel: +44 (0)20 7587 3228 ______________________________ Printed name Fax: +44 (0)20 7587 3210; Email: [email protected] _______________________________ Title ***  ANNEX 3 ACCEPTANCE FORM I hereby accept the invitation of the International Maritime Organization (IMO) to participate in the Regional seminar on the Implementation of the 2012 Cape Town Agreement for CIS and Eastern Europe region to be held in Saint Petersburg, Russian Federation, from 8 to 11 December 2015. I confirm that: 1 I will refrain from engaging in political, commercial and any activities other than those governed by the seminar programme; 2 I have understood the objective, scope and subject areas of the seminar as well as its programme; 3 I have noted the profile necessary for the seminar and I am confident that I meet the requirements; 4 I will advise IMO immediately if I am unable to attend the seminar; 5 I am prepared to bear the cost of all medical expenses I may incur and am aware that IMO will not assume any relevant responsibility. I understand I am responsible for arranging any necessary insurance cover for my trip; 6 I shall complete and submit the evaluation questionnaire for the lecturers at the end of the seminar and the ex-post evaluation questionnaire that I will receive at least six (6) months after the completion of the seminar; and 7 I am competent in the language to be used in the seminar. Signature of Participant _____________________ Name of Participant _____________________ (Printed) Official address _____________________ _____________________ _____________________ _____________________ _____________________ Date _____________________ _______ From: Rene Arikas Sent: 5. november 2015. a. 8:28 To: Keiu Leopard Subject: FW: Regional Seminar on implementation of the Cape Town Agreement - 8- 11 Dec in St. Petersburg Attachments: Invitation letter - Estonia.pdf; Nomination form.doc PPsse From: Ivaylo Valev [mailto:[email protected]] Sent: Wednesday, November 04, 2015 7:28 PM To: Rene Arikas <[email protected]> Cc: Keiu Leopard <[email protected]>; VA_eva <[email protected]>; Amr Hussein <[email protected]> Subject: Regional Seminar on implementation of the Cape Town Agreement - 8-11 Dec in St. Petersburg Dear Mr Arikas, Please find attached an advanced scanned copy of the Invitation Letter to the IMO regional seminar on the Cape Town Agreement. The original has been posted. Best regards, Ivaylo Valev Iva ylo Val ev He ad CIS /Ea ster n Eur ope Sec tion Tec hni cal Co ope rati on Divi sio n e: ival ev @i mo. org | t: +44 (0)2 0 758 7 322 8 | w: ww w.i mo. org This e-mail may contain confidential or privileged information and is intended solely for the use of the named recipient(s). If you are not the intended recipient you may not disclose, copy, distribute or retain any part of this message or attachments. If you have received this e-mail in error please notify the sender immediately via e-mail. Please consider your environmental responsibility before printing this e-mail.