2004 MTSC Registration Form

2007 MAT MTSCMTSC RegistrationRegistration

FormForm

Name Job Title Country Company E-mail Tel. No. Yes, I would like to register for the MTSC training course, and confirm that I have read the agenda.

Registration This year’s MTSC training will be held at: Visionary Management Academy http://www.visionaryco.com.tw/index.aspx# 4th Fl., No. 3, Sec. 3, Chung Hsin Road, Room B01 Shing Tien City, Taipei, Taiwan

MOXA will provide daily transportation between the hotel and the training site Please book a room for me at the LAKE HOTEL for 3 nights (Sept. 18, 19, 20). I agree to pay room rate shown for my room choice below. Accommodation Please book a room for me at the LAKE HOTEL for 4 nights s (Sept. 18, 19, 20, 21). I agree to pay room rate shown for my room choice below.

Select one of the following room types. Lake View Appro. Single USD 70. (incl.VAT) Per day

Grand View Appro. Suite USD 77. (incl.VAT) Per day

Executive King Appro. USD 84. (incl.VAT) Per day

Executive Appro. Twin USD 88. (incl.VAT) Per day

Sweetie Suite Appro. USD 102. (incl.VAT) Per day

Please use the “Additional Comments” box below to list special requirements. Pick-up Service We will arrange pick-up service for you free of charge from the airport. Please provide us with your flight information. Yes, I would like MOXA to arrange pick-up service from the airport. Arrival Flight Information Flight Number: ______Arrival Date: ______Arrival time: ______Departure Flight Information Flight Number: ______Departure Date: ______Departure Time: ______

No, I do not need pick-up service.

Select your shirt size (please check the size chart below). S M L XL XXL XXXL

Shirt Size Size S M L XL XXL XXXL Chest Measurement 38" 40" 42" 44" 46" 48" (97 cm) (102 cm) (107 cm) (112 cm) (117 cm) (122 cm)

Additional Comments

Thank you for filling out this form. The information you provide will assist us in arranging the course.

Please fill out the registration form and email it to your regional sales representative . Region Regional Sales Asean, Korea [email protected] Oceania, South Asia, Middle East [email protected] Japan [email protected] Russia, CIS [email protected]

Thank you!