INCLEN Global Meeting XVII - Registration Form

REGISTRATION FORM
INCLEN Global Meeting XVII
BANGKOK, OCTOBER 15-18, 2000

Please use this form (photocopy allowed) for registration and accommodation reservation. Please fill it in and print it. Return this form with payment to the secretariat office.

Family Name:

First Name:

Title:

Organization:

Address:

Country:

E-mail:

Tel:

Fax:

I. Global Meeting Registration

Until September 15, 2000 After September 15, 2000

Participant 300 US$ 350 US$

Accompanying Person 150 US$ 180 US$

(number of accompanying person = )

Registration Fee = US$

II. Hotel Registration ( Montien Riverside Hotel )

1 Single (100 US$ per night) Room
1 Twin (110 US$ per night) Room

Hotel Deposit for One Night = US$
Date of Arrival:

Date of Departure:

Number of Nights:

Total Payment = US$

Method of Payment
Bank Draft payable to account "INCLEN Global Meeting XVII"
Wire Transfer / Bank Transfer to account "INCLEN Global Meeting XVII" account number 038-2-68710-4
Credit Card:

VISA

American Express

Master Card
Card Number

Expiration Date

Name of the Card Holder

Signature

Date

Back to the Table of Contents

	Until September 15, 2000	After September 15, 2000
Participant	300 US$	350 US$
Accompanying Person	150 US$	180 US$

REGISTRATION FORM INCLEN Global Meeting XVII BANGKOK, OCTOBER 15-18, 2000

REGISTRATION FORM
INCLEN Global Meeting XVII
BANGKOK, OCTOBER 15-18, 2000