APOSHO 29 Conference

FORM  A

REGISTRATION FORM

 

Personal Information

Title First Name Middle Name Last Name

Organization / Company

Job Title Department

Address

City State Country

Phone Fax Mobile phone  

Official E-mail Personal E-mail 

Passport Number Nationality                                                                      

Please Tick:   APOSHO Member      No       Yes      Honorary Member       Head Delegate

Attendant
Category 		Registration
Before  Apr ’ 14		  Registration
After Apr’ 14/ On Site

 APOSHO MEMBERS /ASSOCIATES

USD 300*             

USD 350*              

FOREIGN STUDENTS

USD 300              

USD 320                

NON-APOSHO MEMBERS

USD 330              

USD 370                

LOCAL PARTICIPANTS

BAHT 3,000         

BAHT 3,200           

LOCAL PRESENTERS

BAHT 2,700         

BAHT 3,000           

GALA NIGHT

USD 100              

USD 100                 

HOTEL (Charges per room per night)

Before  Apr ’ 14

After Apr’ 14/ On Site

Night

- Superior Room( at Novotel )

 

USD 100               

 

USD 120               

- Executive Suite ( at Novotel )

USD 150               

USD 175               

The Registration Fee includes conference materials, lunches and coffee breaks .        *For APOSHO Honorary Member and Head Delegate, Registration Fee is waived.

All accommodations are at the Novotel. The hotel charge includes either twin beds or one double bed with daily breakfast for two and daily free bus shuttle service from hotel to the Conference Venue.





Note:                                                                                              


-All bank charges should be paid by registrants.
-All cancellation must be written via fax or e-mail
on latest April 14th 2014. If the registered participant
unable to attend, a representative is allowed to replace            
on his/ her behalf. Please inform us for the name change
2 weeks before 1st July 2014.                                                                      

       Payment should be transfered to our bank account.
Account Name: The Safety and Health at Work Promotion       Association   (Thailand).
Bank: Bangkok Bank         Branch :Thalingchan
Account No: 211-0-60928-2
Refund 50% before April 14th 2014. No refund afterwards
Swift code: BKKBTHBK