International Senior Project Conference in Engineering and Technology

1. International Senior Project Conference in Engineering and Technology Bangkok, Thailand 27-29 March 2014 CONFERENCE REGISTRATION FORM Print or Type 2 1 Name Last Name Middle Name Prof./Dr./Mr./Ms./Mrs. First Name Department Institute/University E-mail: Mailing Address Street/PO Box City Province/State Country Postal/Zip Business Telephone: Business Fax: I have special needs (please check all that apply and attach description): visual vegetarian kosher access audio other OPTIONAL: Please indicate your Emergency contact name & telephone number Emergency Contact: Emergency Telephone: I am registering as: (check all that apply) Technical Paper Presenter Poster Session Presenter Conference Attendee Other REGISTRATION FEES The registration fee will be fully waived for only the main presenter of a technical paper or poster. The registration fee is collected solely to cover costs for accommodation, food, and an optional tour (on March 29). Please check the appropriate option below: 2-Night Stay Without Tour (March 27-28) 2-Night Stay With Tour (March 27-28) R01 Presenter with KMUTT support** WAIVED WAIVED R02 Presenter without KMUTT support/Attendee** 2300 THB/HEAD 2800 THB/HEAD R03 Presenter without KMUTT support/Attendee (Single room) 3600 THB/HEAD 4100 THB/HEAD ** Applicable for twin sharing only. PAYMENT METHOD We accept only cash in Thai Baht (THB) for the registration fee. You can make the payment to our staff at the conference registration desk on March 27, 2014. We apologize for any inconvenience regarding this restriction for the payment form. Please return this form with all requested information to Miss Phattaree S. ((preferably) E-mail: ice_engineering@kmutt.ac.th and praphasiri@gmail.comFax: +66-2427-8787)