I plan to attend the symposium.

Last Name :
First Name :
Title :
Organization/Institution :
Address :
Work Phone :
Fax :
Home Phone :
E-mail :

I have enclosed the registration Fee US$ 50.00 per person and one night deposit accommodation total US$

Draft payable to "The Thai Women Watch", current a/c No. 043-3-03659-9, the Siam Commercial Bank , New Petchburi Road Branch.

Please check accommodation request on Campus Single rooms for special request, available 16 rooms
      US$50.00 / per person / per day, 5 meals included
Double rooms
      US$35.00 / per person / per day, 5 meals included
Bunker bed rooms
      US$30.00 / per person / per day, 5 meals included

Special diet request (tick only if required)
Vegetarian Other (please specify)

Special facilities request (please specify)

Arrival Date:
Carrier: Flight:

Departure Date:
Carrier: Flight:

Transfer request upon arrival	Yes	No
Transfer request upon departure to BKK Intl. Airport	Yes	No
Transfer request to Bangkok	Yes	No

I wish to attend the following Workshops
(Please check your issue of concern)
Women & Poverty
Education & Training of Women
Women & Health
Violence Against Women
Women & Armed Conflict
Women and the Economy
Women in Power & Decision Making
Institutional Mechanisms for the Advancement of Women
Human Rights of Women
Women & the Media
Women & the Environment
Girl-Child

I plan to send one member to join the Youth Forum

My organization is interested in organizing / sponsoring Workshop
Title :
Name of Convenor :