Surname (Family name): Ivanova
First name: Tatiana
Organisation: Usher-Forum
I am (delete as appropriate): Deafblind participant
A. Deafblind participant
B. Interpreter-guide / assistant / family member to
deafblind participant
named:
C. Floating interpreter-guide / visiting professional
MY CONTACT DETAILS
E-mail: tatevik77@inbox.ru
Telephone and/or Fax: 8-(495)456-87-52
Home address: 14-100
Street: Lyapidevskogo
Postal code: 125581
City: Moscow
Country: Russian Fediration
INFORMATION FOR THE PROVIDER OF ACCOMMODATION
Date, place and state of birth: 18.04.1977 Moscow. Russia
Nationality: Russian
Passport number: 49 894040
ACCOMMODATION AND/OR SPECIAL DIETARY NEEDS
I want to share room with: Valentina Kostyunina
I request Vegetarian meals: YES - NO NO
I need a special diet as follows: NO
SPECIAL REQUESTS
I read (delete as appropriate): large print
Braille / large
print / normal print
I use (delete as appropriate): Sign language, Spoken
Sign language / Lorm / Malossi /
Spoken language / Written language /
other:
I am a wheelchair user: YES – NO NO
I will bring a guide dog with me: YES – NO NO
Other:
I agree to a publication of my contact details in the
List of participants: YES
– NO YES
MY TRAVEL PLAN
Please note that host does not organize transport from
the airport to the venue.
We will provide you with detailed instructions how to
get to the venue.
Arrival
Arrival date and time: 01.
08. 2011 г.
Departure place in Helsinki: Airport / Railway station
/ Harbour
Departure date and time: 07.
08. 2011г.