Information sheet

I) INFORMATION REGARDING RESSOURCE PERSONS

(Please check that the information is correct and complete or correct it as necessary)

Participant ID: 	

My name was proposed by:

Name:		Country: 	
First name		Mother tongue: 	
Age		Working language: 	
Sex	 Female   Male 	Email: 	
Address	
	Another email where you can be contacted if you do not have a personal address:

College	
	
Contact: 

Tel 	
	
Fax : 

II) JOURNEY AND STAY

a) Concerning the visa

Passport no.:
	Date and place of issue:		Date of expiry:		

PLEASE FAX US A COPY OF YOUR PASSPORT, SHOWING YOUR NAME, FIRST NAME, PASSPORT No. , TO Mrs KARINE GOASMAT (FAX: 33 143 14 75 99) OR SEND A SCANNED COPY BY EMAIL (lillemondeorganisation@fph.fr)
	
! You must carry out the procedures necessary at the French Embassy in your country by using the invitation enclosed. Please inform Mrs Karine Goasmat (Phone: 33 (0)1 43 14 75 75 Fax: 33 (0)1 43 14 75 99 Email: lillemondeorganisation@fph.fr) as son as possible if you have difficulties in obtaining a visa.

b) Concerning your journey 

•	The reservation of plane tickets for regular airlines (economy class) are EXCLUSIVELY managed by the team at the Charles Leopold Mayer Foundation for the Progress of Humankind (FPH). Equipped with your passport and, possibly, your "Shengen" visa, all you will have to do is to withdraw your prepaid plane ticket from the counter of the company whose name you will be informed of later, with the number of your reservation file as soon as we have all the elements concerning your itinerary, your airport of arrival near Lille (Paris, Bruxelles, London, Amsterdam) and the journey times. Planes are filled very quickly so we must make your reservation as soon as possible.
•	Unless instructed otherwise by you, the departure and arrival will be at the airport nearest your home and the dates are planned to permit your arrival at Lille on 1 and 2 December 2001 in the morning and departure as early as possible from 10 December in the evening. 
•	Merci donc de nous indiquer ci-après les informations suivantes: 

Airport of departure 		
Airport of arrival when returning	

•	You can take advantage of this journey to stay several extra days in Europe, though it is understood that they will be at your expense.

 YES, I would like to profit from the journey to stay several extra days in Europe at my expense	 NO 
If yes,

Desired date of departure 		
Desired date of return		
Airport of departure 		
Airport of arrival 		

Specific observations: 

	

c) Concerning your accommodation and catering

The Charles Léopold Mayer Foundation for the Progress of Humankind (FPH) will pay for your accommodation and meals during the Assembly. The meals will be adapted to permit each person to continue with their dietary customs and convictions (the Assembly occurs at the same time as Ramadan). You will be accommodated in single rooms in standard category hotels located in the city centre. The meeting places are accessible by foot, but you will also be able to use shuttle services to reach them (Lille Grand Palais: Palais des Congrès de Lille, 1 Bd des Cités Unies 59800 Lille; Le Nouveau Siècle: 8, Place Mendès France 59800 Lille). 

III) YOUR MAIN CENTRES OF INTEREST (cf. accompanying note, chapter I d) )

a) The topical focus that interests you most (tick one of the boxes):

 Focus 1 Values, education, culture	 Focus 3 Governance
 Focus 2 Social economics	 Focus 4 Humanity and the biosphere

You can consult web page: http://www.alliance21.org/fr/themes/ for more information 

b) The tropics that interest you most within the different topical foci (you can tick as many boxes as you wish, but you undertake to study the proposals booklets on these topics that will be sent to you before the Assembly.

Focus 1 Values, education, culture

 Art and Society, Co-ordinator: Hamilton Faria 
 Intercultural dialogue,  Agusti Nicolau 
 Education, Laura Maffei 
 University, Alfredo Pena-Vega 
 Social control of the Sciences,  Frédéric Piguet 
 Gender relations,  Nadia Aissaoui 
 Information and Communication Technologies (ICTs),  Valérie Peugeot 
 Media, Siddhartha

Focus 2 Socioeconomics, social economy 

Focus co-ordination: Marcos Arruda, Laurent Fraisse and Philippe Amouroux
 Fair trade, Pierre Johnson 
 International trade, Joseph Rocher 
 Ethical consumption, Flávia Soares 
 The debt, Alejandro Bendaña 
 Sustainable development, Nova-CIS 
 Social economy, Humberto Ortiz et Laurent Fraisse  
 The enterprise and solidarity, Martial Cozette 
 Women and the economy, Cécile Sabourin 
 Social finance, Renée Chao Beroff 
 Social money, Heloisa Primavera 
 Production, technology, investment, Ramesh Ramaswamy 
 Economic policies, Jaerson Bezerra 
 Tax policy and social security, Ceci Jurua 
 Work, employment, activity, Claudio Nascimento  
 Towards sustainable finance, Paul Dembinski 

Focus 3 Governance

 Citizenship and political renewal, Manola Gardez Rauss 
 The State and development, Pierre Judet et Monzon Traore 
 Integrated territorial management ,Paul Maquet Makedonski 
 World governance, Pierre Calame 
 Security and conversion of the arms industry, Richard Pétris 

Focus 4 Humanity and the biosphere

 Biodiversity and GMOs, Robert-Ali Brac de la Perrière 
 Water, Larbi Bouguerra 
 Industrial ecology, Suren Erkman 
 Environmental education, Yolanda Ziaka 
 Energy, Mycle Schneider 
 Forests, Luis Felipe Cesar 
 Soils, Rabah Lahmar 

IV) THE NETWORKS THAT YOU THINK YOU CAN ASSOCIATE WITH PREPARING THE ASSEMBLY (CF. accompanying note, Chapter II c) )

NAMES OF THE ORGANISATION/NETWORK	ADDRESS, etc.	

Phone: 
Fax: 
Email 

	

Phone: 
Fax: 
Email 

	

Phone: 
Fax: 
Email 

	

Phone: 
Fax: 
Email 

If you would like information on the Alliance to be sent to certain persons, etc., please note their addresses.

V) THE JOURNALISTS TO WHOM YOU WOULD LIKE A PRESS BOOK TO BE SENT (cf. accompanying note, Chapter II d) )

NAMES, FIRST NAMES	ADDRESSES	

Phone: 
Fax: 
Email 

	

Phone: 
Fax: 
Email	

Phone: 
Fax: 
Email	

Phone: 
Fax: 
Email	

VI) INITIAL IDEAS ON THE CONTRIBUTION OF YOUR PEOPLE TO THE WORLD OF TOMORROW (cf. accompanying note, Chapter II e) )

	

	

	

Please return this sheet to Claire Launay or Chantal Tien before 30 September at the latest 
 by email lille@echo.org 	by fax: 00 33 1 43 14 75 99   		by mail:  fph - 38, rue St Sabin F-75011 Paris