Registration

Registration Information

Please fill in the following form to register for the PERCH-CIC Congress VI conference.

A: Basic Information

Title
First name
Family name
Institution
Address
City
Country
Postal code
E-mail
Telephone (office)
Telephone (mobile)
Fax
Membership statusPERCH-CIC member Non PERCH-CIC member
Role Author Co-author Just attending Exhibitor Student
B: Additional Information (if applicable)

Arrival Date/Time Airline
Departure Date/Time Airline
Accompanying person(s) (if any)

C: Conference Registration Fees

Please indicate applicable fee type:

(Registration includes accommodation for the nights of May 3 – May 5, three luncheon buffets on May 4 – May 6, five coffee breaks, and two dinners on May 3 and May 5)

Regular 10,000 Baht
Student 8,000 Baht (shared hotel accommodation, two participants per room)
Optional extra night(s) (1,500 Baht/night): May 2 May 6 May 7 May 8

Total Fee = 10,000 Baht. Payment shall be done on-site at the registration desk (in cash only).

Other comments:

Contact

Please contact perch.cic@gmail.com for any registration problems or issues.