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					                                     REGISTRATION FORM
The 5th IIEP-SEAMEO RIHED Workshop on Institutional Restructuring in Higher Education
                                               and
                                  Educational Trip to Malaysia
                                       26 July-2 August 2009
    (Deadline for Application is 30th June 2009, Participants are limited to 10 persons ONLY)
 _____________________________________________________________________________

Section 1: Registration Details
Name: Mr./ Mrs./ Miss./ Ms. ……………………………………………………………….……………………………………….……………..……(English)
       ………………………………………………………..………………………………..…………….……………………………………..………………………………(ไทย)
Institution: ……………………………………………………………………………….……………………………………………………………………………………………….…
Academic Title: ……………………………………………..……….… Administrative Position: ……………....…………...…..……....…….…
Office Address: ……………………………………………………………………………………………………..…………………………………..……...................
…………………………………………………………………………………………………………………………………………………………..………………………………………………
Tel : …………….………………………………..……………..….…… ……... Fax : ……………………………………………………..……………………………........
Mobile Phone: …………………..………………………..…………….. E-mail: …………………………………………………………………………….……………
Contact Address: ………………………….……………………………….…………………………….………………………………………..…….....................
Name of Contact Person (e.g. secretary/assistant): ……………….……………………………..……………………………………………….
Tel: ……………………………………………………… …………….……………. E-mail: ………………………………………………………………………………………...

_______________________________________________________________________________


Section 2: Meal Preference (Please specify for example no beef or Moslem food)

…………………………………………………………………………………………………………………………………………………………..………………………………………………

_______________________________________________________________________________


Section 3: Travelling

International to Kuala Lumpur: by Thai Airways / Economy class / Single rate

Royal Orchid Plus Number: …………………………………………………..……………………………………………………………………………………………

Domestic to Kota Kinabalu: by Malaysian Airlines / Economy class / Single rate
_______________________________________________________________________________


Section 4: Pricing and Method of Payment (Please read note 1, 2)

     59,000 Baht per person for a single room accommodation, economy class




                                                1
Note 1: This price includes:
   Single rooms accommodation in 4-star hotels;
   5 day IIEP-SEAMEO RIHED Workshop);
   Health and accidental insurance;
   Local transportation;
   Meals;
   Single-rate, return economy air ticket between (BKK-KL-BKI-KL-BKK);
   Sightseeing, shopping and city-tours (admission charges for commercial attraction included
     and cannot be refunded);
   Printed materials; and
   Programme management fees.

* Important: the above price is quoted for a ‘single rate’, return economy ticket between BKK-KL-BKI-KL-BKK
during 26 July-2 August only. If any participants wish to travel by business class or extend/change the length
of their stay, a quoted price for your required will be issued.

Note 2: The above pricing will not include:
   expenses incurred from your extended length of stay
   overloaded luggage
   food/beverages/entertaining events not mentioned in the programme itinerary

Please transfer your payment to:
Account holder: SEAMEO RIHED                         Saving Account number: 003-2-90026-8
Bank name: Thai Military Bank Public Company Limited Branch: Phyathai

Please send the pay-in-slip with the participant’s name to SEAMEO RIHED by:
Fax: 02 644 5421 or Email: Ms. Thanthakorn Phuangsawat: thanthakornp@gmail.com
Further information, please contact: Ms. Thanthakorn Phuangsawat Tel: 02 644 9856-62 ext 101 /
087 354 1906 or Mrs. Wachareeporn Nilratt Tel: 02 644 9856-62 ext 104 / 081 279 0599

_______________________________________________________________________________


Section 5: Cancellation and Refund Policy
    1) No refund in the event of cancellation after 10th July 2009, however the nomination of
       another person in substitution of yourself at this point is still acceptable (before 15th July
       2009).
    2) Full refund will be made if the cancellation is caused by SEAMEO RIHED.


I accepted all details applied to the 5th IIEP-SEAMEO RIHED Workshop on Institutional
Restructuring in Higher Education and Educational Trip to Malaysia during 26 July-2 August 2009


                                 Applicant’s Signature ……….……………………………………………………………….………...……

                                                           (                                              )

                                                           Date ……………………………………………..………….…..........


Please send the registration form to reserve your seat by Fax: 02 2644 5421 before 30th June
2009. Please kindly make your payment within 10th July 2009 (to guarantee your reservation).
Late applicants are requested to make payments immediately after your application.

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