REGISTRATION FORM THE SECOND SOUTH EAST ASIA WATER FORUM by Noodlezs

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									         THE SECOND SOUTH EAST ASIA WATER FORUM
         29th August – 3rd September 2005, Nusa Dua, Bali - Indonesia
                                                                                      REGISTRATION FORM



       1. Name in Full: Mr./Ms./Mrs.
       2. Title or Official Position:
               Register as       Speaker             Participant        Exhibitor
       3. Region / Organization
       4. Contact Address
                          Tel                       Fax                  E-mail

       5. Do you need a letter for visa application to enter Indonesia? Yes No
          For those who require an entry visa to Jakarta, please complete the information bellow:
          Passport Number                     Place of Issue
          Nationality                         Date of Birth     dd               mm        yy
          Date of Issue                       Date of Expiry

       6. Arrival / departure Information: Arrival in Ngurah Rai Airport, Bali
          Date of Arrival                                  Date of Departure
          Flight No. and ETA                               Flight No. and ETD

       Visa Information:
       The department of Justice and Human Rights has officially determine that as 1 February 2004:
       1. The Free Visa Facility (length of stay max. 30 days) will be issued to citizens of the following
           countries: Brunei, Malaysia, Philippines, Singapore, Thailand, Vietnam, Hong Kong, Macao,
           Morocco, Chile, Peru.
       2. The Visa-on-Arrival Facility (length of stay max. 30 days) will be issued to citizens of the
           following countries: Australia, Argentina, Brazil, Canada, Denmark, Finland, France, Germany,
           Hungary, Italy, Japan, New Zealand, Norway, Poland, South Africa, South Korea, Switzerland,
           Taiwan, United Kingdom, United Arab Emirates, United States.
       3. Citizens of countries not stated above are required to apply for a visa at the Indonesian
           Embassy/ Consulate in their country of domicile.

       Please tick relevant information :
       [ ] I will present a case study / paper
       [ ] I will present a poster
       [ ] I will participate in the sessions but will not make a presentation
       [ ] I will / will not join the Side Events
                                                          th
       Participant Fee : US$ 200 (before August 5 2005)
                                                th
                         US$ 250 (after August 5 2005)

       *bank account for transfer of registration fee will be informed upon receiving your
        confirmation

       Date                                                             Signature




Kindly complete this form and return to:                        Copy of completed form to sent to:
Royalindo Convention International                              Secretariat Committee The Second Southeast Asia Water Forum
PIC Building, Ground Floor, Jl. Teluk betung No.                Ministry of Public Works
43, Jakarta 10230, Indonesia                                    Jl. Pattimura No. 20, Gd. Bank Mandiri Lt. 2, Kebayoran Baru
Tel : +62 21 314 0982, Fax: +62 21 3193 4470                    Jakarta Selatan 12110, INDONESIA
E-mail: mktg@royalindo.com                                      Tel : (62-21) 727-95545, (62-21) 727-95682 Fax: (62-21) 727-95682
Contact Person: Mr. Fadhlan Karim and Ms. Maya                  Website: www.ssawf.com
                                                                E-mail: sec_seawf@yahoo.com; std_sutardi@yahoo.com;
                                                                         sekretariat@inawater.com

								
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