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Asia Pacific Regional NGO Symposium - Registration and Accommodation Reservation Form

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Email fhumcrh@nontri.ku.ac.th for more Information

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


 
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