Volunteer Election Observer Application If you are human, leave this field blank. 1. First Name * 2. Last Name * 3. Your Ukrainian Mobile Phone Number. If you do not have a Ukrainian number, then list your regular mobile number. * 4. Email Address * 5. What languages do you speak without the need of an interpreter (include your native language)? * 6. For those arriving from outside Ukraine, a driver will meet you at the airport. Please indicate your return flight date and time if you want transportation to the airport upon your departure from Ukraine. * 7. This is a limited budget mission, therefore observers are expected to cover their own meals when not provided by the hotel. Do you agree to cover your own meals? * Yes No 8. COD provides twin occupancy accomodations during the mission. If you have an observation partner you wish to share with, or if you need single occupancy, please specify. 9. RELEASE & ACKNOWLEDGEMENT: I acknowledge that I have read the Committee for Open Democracy Volunteer Observer Handbook for the Ukrainian Parliamentary Elections as of July 13, 2016 available at https://www.committeeforopendemocracy.org/wp-content/uploads/2010/10/COD-Ukraine-Volunteer-Manual-July-2016.pdf . I have read and understand the contents of this document and will act in accordance with these policies and procedures. You should also be familiar with the United States State Department Travel Warning for Ukraine issued on June 17, 2016. I hereby release, acquit, satisfy, and forever discharge the Committee for Open Democracy (COD), and its officers and agents, of and from any and all manner of action, cause of action, suits, debts, dues, sums of money, accounts, reckonings, bonds, bills, specialties, covenants, contracts, controversies, agreements, promises, variances, trespasses, damages, judgments, executions, claims and demands whatsoever, in law or in equity, which I now have, or which any personal representative, successor, heir or assign of said parties hereafter can, shall or may have against said Committee for Open Democracy, for, upon or by reason of any matter, cause or thing whatsoever, from the beginning of the world to the day of these presents. This release includes claims arising from, but is not limited to, acts of terrorism, civil unrest, war-declared or undeclared or insurrection. I hereby give COD permission to accredit me with the Central Election Commission of Ukraine for purposes of international election observation relating to the July 17, 2016 special parliamentary election. * I hereby agree to all terms and conditions. listed in the release above.