I plan to attend the symposium
Last Name:_____________________________ First Name:______________________
Title:______________________ Organisation/Institution:________________________
Adress:________________________________________________________________
______________________________________________________________________
Work Phone:______________ Fax:_________________ Home Phone:______________
E-mail:_________________________________________________________________
I have enclosed the registration fee US$50 per person and one night deposit accommodation total US$_____________________
Draft payable to The Thai Women Watch current a/c No. 043-3-036599,
The Siam Commercial Bank, New Petchburi Road Branch.
Please check accommodation request on Campus
[ ]Single room for special request, available 16 rooms
US$50.00/person/day, 5 meals included
[ ]Double room
US$35.00/person/day, 5 meals included
[ ]Bunker bedroom
US$30.00/person/day, 5 meals included
Special diet request
[ ] Vegetarian [ ] Other (please specify)_____________________________________
Special facilities request (please specify)____________________________________
Arrival Date:_______________ Airline:_________________ Flight no.:__________
Departure Date:______________ Airline:________________ Flight no.:__________
Transfer request for Arrival [ ] for Departure to Airport [ ] for Departure to Bangkok [ ]
I wish to attend the following workshops
(Please check your issues of concern)
[ ] Women and Poverty
[ ] Education & Training of Women
[ ] Women & Health
[ ] Violence Against Women
[ ] Women and Armed Conflict
[ ] Women and the Economy
[ ] Women in Power & Decision Making
[ ] Institutional Mechanisms for the Advancement of Women
[ ] Human Rights of Women
[ ] Women & the Media
[ ] Women & the Environment
[ ]Girl-Child
[ ] I plan to send one member to join the Youth Forum.
[ ] My organisation is interested in organising/sponsoring/Workshop
Title:_____________________________ Name of Convenor:_____________________
[ ] I plan to contribute a paper on the topic __________________________________
[ ] I will need a space for Exhibition / Display / Bazaar Booth
[ ] My organisation is contributing a cultural presentation of not more than 7 minutes.
Please complete the form and send to:
The Asia-Pacific Regional NGO Symposium
Secretariat: 6th Floor, Kasetsart University Golden Jubilee and Information Center
50 Phaholyothin Road, Chatuchak Bangkok 10900, Thailand
Tel: (662)942-8500 ext. 4625 Fax: (662)9428617
e-mail: fhumcrh@nontri.ku.ac.th