REGISTRATION FORM
20th Biennial Conference of
the Asian Association for Biology Education
(AABE 20)
Please put X in the [ ] provided. Please
type or write in block letters
Name
(Prof.,Dr.,Mr.,Ms.)…………………………..….. …………………………….……
Given name
Family name
Office
Address………………………………………………………………….………………..
……………………………
…………………………. ………………………..
City
Country
Postcode
Telephone…………………….Fax……………..….E-mail………..……………
Home
Address ……………….……………………………………………………………………
………………………… …………………………. …………………………..
City
Country
Postcode
Telephone…………………….Fax………………….E-mail…………..…………
Accompanying
person(s) if any:
1)…………………………………………………………
2)…………………………………………………………
I
wish to register as [ ] Normal participant
[
] Student (a copy of student ID is required)
I
intend to present a paper entitled:
………………………………………………………………….………………………….
…………………………………………………………………………….……………….
……………………………………………………………………………………….…….
[
] Oral presentation [
] Poster
I
wish to join the following activities:
[
] Informal gathering [
] Education tour
[
] Welcome reception [
] Excursion
[
] Farewell dinner
Registration
fee [
] Participant US$
160
[
] Accompanying person US$
75
[
] Student US$
75
Accommodation International
Center, Chiang Mai University
[
] Single room US$
17
[
] Double room US$
20
Check
in date…………………….
Check out date…………...
Total……………nights (One night
deposit is required)
Payment
[ ] I
have enclosed herewith a bank draft payable to “Morakot
Sukchotiratana” the sum of US$..........
[ ] I
have remitted the above sum by bank transfer through my bank………………………………….
(name of your bank) to the Account Name ”Marakot Sukchotiratana” Account Number
667-6-00023-0 the Siam
Commercial Bank Public Company Limited, Chiang Mai University
Sub-branch
[ ] I
will pay on site
Signature……………………………………. Date…………………………………….
Please return the completed registration
form with the remittance by 30 October, 2004, to Prof. Morakot
Sukchotiratana, Department of Biology, Faculty of
Science, Chiang Mai University, Chiang Mai 50200 Thailand, Fax. 66 53 892259