Registration Form
A Pan Asia International Conference on
THE RIGHTS AND PLIGHT OF CHILDREN
Organized by the John Paul II Centre for Catholic Social Thought
In Collaboration with
The Pontifical Council for Justic and Pease, The Holy See
1. Participants Information
(All fields with * are required. Please complete all the information requested)
Title*:
Prof.
Assoc. Prof.
Asst. Prof.
Dr.
Mr.
Mrs.
Ms
Other
Last Name*:
First Name*:
Middle Name:
Position*:
Institution*:
Mailing Address:
Phone:
Mobile:
Fax:
Email*:
A confirmation message about your registration will be sent to your email after registration.
Accompanying Person(s):
1) Last Name:
First Name:
2) Last Name:
First Name:
3) Last Name:
First Name:
(All information submitted will be kept confidential)
Paper Presenter
Non-Paper Presenter
Title of Paper*:
Conference Sub-Theme*:
Issues
Regions
Both
2. Registration Fee
*
Overseas Participants
Number of person(s) attending:
-
1
2
3
4
5
6
7
8
9
10
person(s) Fee:
$US
Amount: US$
Local Participants
Number of person(s) attending:
-
1
2
3
4
5
6
7
8
9
10
person(s) Fee:
$US
Amount: US$
Total registration fee:
Amount:
US$
NOTE
* Full registration fee (early bird) before Sep 30, 2008
- Overseas participants
- Local participants
: US$ 220 per person.
: US$ 75 per person.
* Full registration fee before Nov 30, 2008
- Overseas participants
- Local participants:
: US$ 250 per person.
: US$ 100 per person.
Special dietary requirements
*
:
Vegetarian food
person(s)
Halal food
person(s)
Non Vegetarian food
person(s)
3. Request for Accomodation
Hotel Name
Room Size
Rate
No. of Room(s)
No. of Night
Amount (US$)
Au King David Hall
Single residency
US$ 127
Choose No. Of Person(s)
1
2
3
4
5
6
7
8
9
10
Choose No. of Night
1
2
3
4
5
6
7
8
9
10
Share residency (2 persons)
US$ 95/person
Choose No. Of Person(s)
1
2
3
4
5
6
7
8
9
10
Choose No. of Night
1
2
3
4
5
6
7
8
9
10
Total
(Rates are inclusive of Daily breakfast-nett per room per night and transportation service from-to Suvarnabhumi Airport)
Check In*:
Date:
January 20, 2009
January 21, 2009
January 22, 2009
Time:
hh:
mm
AM
PM
(h:mm eg. 1:30 PM)
Check Out*:
Date:
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January
February
March
April
May
June
July
August
September
October
November
December
2009
Time:
hh:
mm
AM
PM
(h:mm eg. 1:30 PM)
Transportation Service from-to Suvarnabhumi Airport:
Arrival Information
Date:
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02
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January
February
March
April
May
June
July
August
September
October
November
December
2009
Time:
hh:
mm
AM
PM
Flight/Airline:
Departure Information
Date:
01
02
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07
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09
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January
Febuary
March
April
May
Jun
July
Auguest
September
October
November
December
2009
Time:
hh:
mm
AM
PM
Flight/Airline:
4. Thai Cultural Night and Dinner on January 22, 2009
*
Siam Niramit Cultural Show and Dinner: Number Attending
person(s). (Rates are inclusive of registration fee)
5. Payment Information
Bank Transfer:
Total amount to be transfered to:
ASSUMPTION UNIVERSITY
Account No: 345-1-02188-8
Bank of:
Ayuthaya Public Co., Ltd, Assumption University Rama IX-Srinakarind Branch, Thailand.
SWIFT CODE AYUDTHBK
Receipt issued to: