UNITED NATIONS
Department of Economic and Social Affairs
Division for Social Policy and Development


Ad-Hoc Committee on Comprehensive and Integral Convention on Protection and Promotion of the Rights and Dignity of Persons with Disabilities, Fifth Session, United Nations Headquarters, New York, January 2005

Pre-Registration Form for Non-Governmental Organizations 


Please fill out the following form without using abbreviations:

1. Name of your organization:

2. Address:

3. Telephone:

4. Fax:

5. E-mail:

6. Please check the appropriate box:

a. Does your organization enjoy consultative status with ECOSOC? Yes [  ]  No [  ]
                                    
b. If yes, which category?  General [  ]    Special [  ]    Roster [  ]

c. Is your organization already accredited to the Ad Hoc according to procedures set in resolution A/56/510?

d. If yes at which session?   First [  ]    Second  [  ]

e. Does your organization wish to send representatives to participate as observers at the third session of the Ad Hoc Committee?  Yes [  ]	No [  ]

7. If you answered Yes to the above questions, please provide us with the names and titles of representatives your organization wishes to send:
a.
b.
c.
d.

8. Please return this form to the Division for Social Policy and Development, Room DC2-1376, United Nations, New York, NY 10017, USA, fax: (212) 963-3062. E-Mail: ngoran@un.org at your earliest convenience.