Institution´s Registration Form

World Mediation Forum

Forum Mondial de Médiation

Foro Mundial de Mediación

 

  Institution´s Registration Form

 
You can send the complete form or just those marked data with * and to send the remaining data by mail or fax. 
Date*  

Name of the Institution: *  

Name of the respponsable:  

First Name*:  

Last Name*  

Spoken lenguajes: Spanish, English, Français,  

Other  

Writen languages:Spanish, English, Français,  

Other  

Prefered language(s) for communicating within the WMF*:  

Spanish, English, Français,  

Address 

Street*   

City*  

Country*  

Phone  

Fax  

Country´s tel. code: 

E-mail* 
 
 
Founctions of the organization: 

Mediation activities and projects: 

Suggestions for development of the WMF: 

Personal involvement in WMF activities? Yes, No, I don´t know. 

(Invitation to also include a resume, professional pamphlets and business cards) 
 
Registration form and information:   

WMF Secretary  

Pº Sta Mª de la Cabeza, 6 2º Izq.  

28045 Madrid, España 
 
Tél.(34).91 530-0921  Fx. (34) 91 530-8602 

E-mail: fmmediac@lander.es

 Registration fees to the following bank account:  

Allied Irish Bank,  

Georges Street, Dun Laoghaire, Co Dublin, Ireland. 

Account number 07113030,  
sort code 93-34-06  
 
    Pay by Card
 
 
 
Yearly registration fees: Persons: 50 U$S     Institutions: U$S 200.-
 
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World Mediation Forum
Forum Mondial de Médiation
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