TUNZA INTERNATIONAL CHILDREN’S CONFERENCE ON THE ENVIRONMENT
ORGANISED BY THE UNITED NATIONS ENVIRONMENT PROGRAMME IN
COOPERATION WITH THE UNEP COMMITTEE FOR THE REPUBLIC OF KOREA
DAEJEON, KOREA
17 - 20 AUGUST 2009
THEME "CLIMATE CHANGE: OUR CHALLENGE"
PLEASE COMPLETE THIS FORM AND RETURN BEFORE 31 JANUARY 2009

PERSONAL INFORMATION: CHILD DELEGATE
 

Family Name

First Name

Date of Birth (dd/mm/yyyy)

Sex

Male: Female:

Address (include code)

Telephone Number (including country code)

Mobile Number

Fax(including country code)

Email

Country

Nearest major airport

 

PERSONAL INFORMATION: CHAPRONE
 

Family Name

First Name

Date of Birth (dd/mm/yy)

Sex

Male: Female:

Address (include code)

Telephone Number (including country code)

Mobile Number

Fax(including country code)

Email

Country

LANGUAGES

English will be the main Language of the Conference. However there will be interpretation services provided for Spanish and French speaking delegates during plenary sessions. Interpretation will not be available for workshops and field trips.

Understand: English/French/Spanish, Yes: No:

Other (please specify)

Speak: English/ French/Spanish Yes: No:

Other (please specify)

SPECIAL NEEDS
 

Mobility(i.e Wheel Chair)

Yes: No:

Hearing

Yes: No:

Sight

Yes: No:

Other (please specify)

SPECIAL DIET

Special Diet

Yes: No:

If yes, please specify

PROJECT DESCRIPTION

Please attach a summary of your environmental project (300 words). You may include photographic and/or visual materials. Tell us how attending the Summit would be of benefit to you. Your project summary should focus on one of the following:


  • School or community environmental project and how it is making a difference.
  • Environmental issues in your community and how you and other children are helping to solve it.

Would you like your project to be considered for presentation at the Conference?
Yes: No:

Name of School and Environmental Club

Name of Community Environmental Club

Address

Telephone (with country and area codes)

Fax (with country and area codes)

E-mail

Name of Leader

PROJECT VALIDATED BY (Project Leader, teacher, other)
ORGANIZATION/SCHOOL DETAILS

Name of project leader/teacher/other

Name of School/Organization

Address

Telephone

Fax

Email

REFERENCES:

Provide two referees - from other organizations who can be contacted to verify the validity of the work of your organization.

Family Name

First Name

Title

Organization

Address

Telephone(with country and area codes)

E-mail
 

Family Name

First Name

Title

Organization

Address

Telephone(with country and area codes)

E-mail
 

FINANCIAL AID

Are you in need of financial aid? Some funding will be available to sponsor travel costs for participants from developing countries.

Would you like to be considered for sponsorship? Yes: No:

Indicate in not more than a 100 words why you should be considered for sponsorship.
 

DECLARATION (by parent/guardian):

I hereby confirm that I have read the documentation and approved the participation of the above named delegate at the 2009 Tunza International Children's Conference on the Environment in Daejeon, Korea.

Please Note:Media will be present throughout the Conference and by signing this declaration you have consented that your child may be covered in articles or on television in connection with the Conference.

Signed

Place and date