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(*) Mandatory fields |
| Family name (*) : |
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| First name (*) : |
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| Sex (*) :
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Male
Female
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Date of birth (*) :
(dd/mm/yyyy)
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| Nationality (*) : |
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| E-mail (*) : |
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| Current postal address (*) :
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Phone number No. 1 (*) :
(country code + No.)
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Phone number No .2 :
(country code + No.)
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Person to be notified in case of emergency (*) :
(name + phone number)
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| Family or professional relationship with any person involved in a case before the Court (*) : |
Yes
No
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Please indicate the nature of the relationship, and the name and function of the person in question (*) :
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