BANGLADESH ELECTION COMMISSION

Sher-e-Bangla Nagar, Dhaka Photo

4 copy
Stamp Size

Election Observation Application Form

(Only for the Foreign Observer)

1. Name : ..............................................................................................................

2. Delegation/Group/Country : ..............................................................................................................

3. Passport details : Number : .....................................................................

Expires on : .....................................................................

4. Nationality : ..............................................................................................................

5. Visa details : Number : .....................................................................

Date of issue : .....................................................................

Place of issue : .....................................................................

6. Address in Dhaka : ..............................................................................................................

..............................................................................................................

Phone : .....................................................................

Fax : .....................................................................

E-mail : .....................................................................

7. Arrival date with flight No. : ..............................................................................................................

8. Probable departure date : ..............................................................................................................

9. Observation experience (if any) : ..............................................................................................................

By signing this application I hereby confirm that I will respect the guidelines issued
by the Bangladesh Election Commission for the role of the International Election
observers. And I confirm that the election commission has the right to reject my
accreditation.

Date: ________________________________
Signature