Registration form - 5th Gathering of the ParlAmericas Open Parliament Network
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      Name(s)
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      Last name(s)
  • *
    Gender
  • *
    Position
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    Chamber or institution
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    Country
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    Email address
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    Cell phone number
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    Office phone number
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    Name of contact person/assistant
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    Contact/assistant's email address
  • Date and time of arrival in Brasilia, Brazil

  • Arrival airline and flight number
  • Last layover on arrival flight
  • Date and time of departure from Brasilia, Brazil

  • Departure airline and flight number
  • First layover on departure flight
  • Note:

    If you submit the registration form prior to booking your flight to Brasilia, please send your itinerary to andrea.marriaga@parlamericas.org before March 20, 2020. If your itinerary is sent after this date, we will not be able to guarantee your transportation between the airport and the hotel.
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    Emergency contact (name, phone number, email address)
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    Allergies or dietary restrictions
  • Reduced mobility
  • If you answered "yes," please specify:
  • *

    In order to facilitate the exchange of contact information between participants, the back of each name badge will have a QR code containing to the individual’s professional contact information (full name, email address, chamber / institution and country). You will be able to share your contact information with other participants by inviting them to scan this QR code, which will allow them to easily add your information to their address book. For more information, please contact Mr. Alvaro Teran at alvaro.teran@parlamericas.org, or by phone at +1(613)947-8999 (office) or +1(613)668-7988 (cell phone - whatsapp).

¡Eso es todo amigos!

* End page and disqualification logic can only be seen in the live survey

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