Nomination form for travel support to 2016 HLPF
The 2016 High Level Political Forum (HLPF) will be held in New York from 11 - 20 July 2016 under the auspices of the Economic and Social Council. The theme for the session will be "Ensuring that no one is left behind". More information is available at https://sustainabledevelopment.un.org/hlpf

UN DESA will provide travel support and daily subsistence allowance to a limited number of representatives of Major Groups and Other stakeholders from developing countries to attend the HLPF. Qualified representatives are invited to indicate their interest to receive funding support by completing the below form no later than midnight (NY time) on Wednesday, 11 May 2016.

The final selection of funded participants will be made by UN DESA DSD in collaboration with the steering group of the MGoS HLPF Coordination Mechanism (for further information please see: https://sustainabledevelopment.un.org/majorgroups/hlpf) taking into account, inter alia, balanced representation of constituencies, gender, age and geography. Also, please note that in order to participate in the HLPF, nominees must register using the following link: http://bit.ly/1q0x0sw . Registration is available for ECOSOC accredited organisations and organisations on the CSD Roster.


Best regards,
DESA DSD
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Full legal name of nominee *
Organization of nominee *
Email address of the nominee *
Does the nominee's organization participate in a Major Group or other stakeholder constituency? *
If the nominee is not part of a major group or other stakeholder constituency, please select none.
Required
Is the nominee's organization in consultative status with the United Nations? *
If the nominee does have consultative status, through which organization is the nominee accredited? *
Is the nominee registered to attend the HLPF? *
Registration is available for ECOSOC accredited organisations and organisations on the CSD Roster using the link http://bit.ly/1q0x0sw
Does the nominee require funding to attend the HLPF? *
Has the nominee previously received travel support from the UN? *
Is the nominee a wheelchair user? *
If answered "YES" to previous question, please provide wheelchair's specifications
If manual or electric, dimensions in cm (width, height, length), weight in kg and type of battery (dry cell or wet cell)
Is the nominee travelling with guide or assistance dog? *
Is the nominee travelling with a Personal Assistant or interpreter? *
If yes,  please fill a second travel form with the name of the PA.
Country of residence of the nominee *
Nationality of nominee *
Gender *
Age *
Rationale for the nomination *
Maximum: 1000 characters
Biography of the nominee *
Maximum: 1000 characters
Link to CV (optional)
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