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Course venue and dates: |
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Surname (Mr/Mrs/Ms/Miss/Dr/Prof): | |
First name: | |
Date and country of birth: | |
Position (if applicable): | |
Name of organisation (if applicable) and address (including post code and country):
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Residential address:
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Tel (BH): |
Tel (AH):
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Mobile tel: |
Fax:
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Email address: |
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PAYMENT OPTIONS (please tick preferences) [ ] 790 euros (37,000 Thai baht) standard fee paid after March 31, 2008 Enclosed is my fee of _______ euros Payment method: |
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| I have read and agree to the conditions of registration as outlined below. | |
Participant's signature: |
Date: |
Conditions of registration:
* Any booking cancelled before March 31, 2008 will be refunded less a |
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Please print out this form, complete it clearly in block capitals and post with your remittance to: Peter Spinks, PO Box 409, Romsey, Victoria 3434, Australia. |