Register for the 3rd International Assembly Name * First Name Last Name Email * Phone Number * Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Organization * Is your organization a member of IWA? * Yes No Do you need Translation? * A majority of speakers will present in English - please indicate if you need translation for a different language. Dietary Restrictions * Halal Vegetarian Pescatarian Vegan Gluten-Free Dairy-Free Nut Allergy Shellfish Allergy No Red Meat Low Salt Low Carb Low Sugar None Please share any accessibility needs you may have * Registration is $150 per person and will cover your hotel room, breakfast and lunch * IWA will follow up with instructions to pay I understand that I need to pay the registration fee of $150 Childcare IWA wants to ensure that the assembly is accessible to mothers. We will do our best to provide accommodations for children during the assembly. There will be an additional registration fee to cover food costs for children over 2 years old. Will you be attending with children? * Yes No If yes, what are their names and ages? Will you need childcare during the 3IA? Yes No VISA Do you need a visa to travel to Malaysia? * Find Visa Requirements: https://www.imi.gov.my/index.php/en/main-services/visa/visa-requirement-by-country/ Yes No Upload image of passport Click here to submit a secure image of your passport for visa processing Address of Embassy Address of Malaysian Embassy in home country Address 1 Address 2 City State/Province Zip/Postal Code Country What events are you attending? you must also register for additional events you attend International Women's Alliance 3rd International Assembly (June 17-18) International Festival for People's Rights and Struggles (June 19-20) International League of People's Struggles 7th International Assembly (June 21-25) Arrival Date Day you will arrive in Malaysia MM DD YYYY Departure Date Day you will depart from Malaysia MM DD YYYY Day of Birth for visa purposes only MM DD YYYY Passport Number and Country for visa purposes only Thank you for registering for IWA’s 3rd International Assembly June 17-18! We look forward to seeing you in Malysia soon! Please be on the look out for follow-up emails with important documents and follow-up!
