NAME and TITLE: ____________________________________________________________________

ADDRESS(ES) : _____________________________________________________________________

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TELEPHONE(S) / FAX / EMAIL / WEBSITES: _______________________________________________

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WORK CONTACT DETAILS: ____________________________________________________________

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• Comments (Please specify how and why you would like to help the work of the TRCME to unfold):

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• Do you wish to be registered as an Associate of the TRCME project ?

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Would you be willing to serve as a Commissioner for the TRCME ? (Evidence of serious long term commitment

to authentic, and neutral Peacebuilding and conciliation work in the Middle East required):

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• Can you recommend other parties who might be appropriate as either Associates or Commissioners

for the work of the TRCME (please give contact details):

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• Educational and Research Background (please include CV if possible):

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• Involvement with mediation and conflict resolution work to date:

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• Involvement with the Middle East:

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* Please send your CV with this form and post to :-
Dr Thomas C Daffern, Director, IIPSGP, Castle of the Muses, Craigard, Carrick Castle, Cairndow, Argyll and Bute, Scotland PA24 6AH.
Telephone: 01301 703053 - Mobile: 07500 238523. Email: iipsgp@educationaid.net