Online registration



Access to registration page. Follow the instruction on the page.



• Personal information

First Name ::
*
Middle Name ::
Family Name ::
*
Title( for Mailing Address)::
Prof. Dr. Mr. Ms.
Institute / Organization ::
Mailing Address ::
Home Office
Address ::
*
Country ::
  *
Telephone (include international code) :
Fax (include international code) :
E-mail :
*
Dietary Request:
Vegetarian Halal Food Others (please specify)

Regular Registration

Early Registration
Before January 31, 2011

Late Registration
January 31- Febuary 20, 2011

On-Site
March 9-11, 2011

Delegate
USD 400
USD 450
USD 500
Accompanying Person
USD 100
USD 150
USD 200

        • Registration Fee for regular participant includes: Admission to All Sessions, Congress Kit, Final Program & Abstract Book, Access to Welcome Reception, Luncheon Symposium, Coffee Break.


        • Registration Fee for accompanying person includes: Access to Exhibition Area, Access to Welcome Reception.


        • Cancellation/ Refund: Any cancellation of registration or replacement of delegates must be made in writing to the Congress Secretariat before January 20, 2011. Refund with 50% deduction for administrative fees and will be processed after the congress. No refunds will be accepted thereafter. Bank Charges will be deducted.


Payment


Credit Card:
I authorize the Organizing Committee of ACD 2010 to change the total amount indicated
above to the following credit card
Wire Transfer to

Account Name : ACOH2011
Bank Name: Siam Commercial Bank Public Company Limited
Branch: Asok Tower
Account Number: 234-206706-1
Swift Code: SICOTHBK
Bank Address: 213/1 Asok Tower Building, Soi Sukhumvit 21, Sukhumvit Rd,
Klongtoeynua, Wattana, Bangkok, 10110 Thailand

* All Bank Transfer charge must be covered by the sender.*
* Please send a copy of the remittance receipt with this form for confirmation.”

 

Summary of registration for payment: AttendeeTHB:
Accompanying Person(s) THB:
Total amount THB:
   
   

 

 
 

In collaboration with:
Hosted:
Organizer by:

WILD BLUE Co.,Ltd, 19/2 Ekkamai 10, Sukumwit 63,Klong Ton, Wattana,Bangkok 10110
Tel : +662 7142590 Fax : +662 7142656
Email: acoh2011thailand@gmail.com

 

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