Fourth International Conference on Austroasiatic Linguistics

C · R · C · L Center for Research in Computational Linguistics

REGISTRATION FORM Fifth International Conference on Austroasiatic Linguistics “Painting the Austroasiatic Family Portrait” Bangkok, November 9 - 11, 2011 ------

Participant Profile

Name:  Prof.  Assoc. Prof.  Asst. Prof.  Dr.  Mr.  Mrs.  Ms. First Name: ______Middle Name: ______Last Name: ______

Sex:  Male  Female Nationality: ______Position: ______Institution / Organization / Agency: ______

Address:______Country: ______E-mail address: ______Phone: ______Fax: ______

Submitted Abstract Title - for paper presenters: ______

Cuisine Choice  General  Vegetarian  Muslim

Registration Fee Please   Thai Scholar 4,000 Baht

 International Scholar 167 US$

 Thai Student 2,000 Baht

 International Students 100 US$

-1- C · R · C · L Center for Research in Computational Linguistics

ACCOMMODATION BOOKING FORM Fifth International Conference on Austroasiatic Linguistics “Painting the Austroasiatic Family Portrait” Bangkok, November 9 - 11, 2011 ------Accommodation Preferences

We recommend staying on the Salaya campus (easy walking distance) at the:

Salaya Pavillion Hotel Thai Baht 1,500-2,500.- per room/night (approx. US$ 50-85, including breakfast) Please contact and book directly at http://salayapavilion.com Do not submit this form to book a room at Salaya Pavillion Hotel.

We have organized accommodation for participants who are interested in booking a room at MU Place: Salaya International House (located about 2km from the University) Thai Baht 800 – 900.- per room/night (approx. US$ 27 – 30.-) [Includes shuttle to and from conference venue. Does not include breakfast] You can book accommodation at MU Place using this form, or you can make arrangements directly through the hotel website at: http://www.muplace.net. Note: participants booking directly with MU Place will make their own way to and from venue. Also note that MU Place has no reception service after 10pm evenings.

Please indicate your preference to book accommodation using this form:  MU Place: Salaya International House

Name  Prof.  Assoc. Prof.  Asst. Prof.  Dr.  Mr.  Mrs.  Ms. First Name ______Middle Name ______Last Name ______Sex  Male  Female Nationality ______ Accommodation Options1 Please  Type of Room Per night (Baht / US$)  Single Bed 800 / 27  Twin Sharing 900 / 30

If twin, sharing room with: ______

1Please reserve on or before Tuesday 1st of November, 2011.

-2-  Booking Details Check-in date: ______Check-out date: ______Number of nights: ______Total Payment: ______Baht / US$2 Other remarks/requests: ______

 For your convenience at MU Place, please indicate your flight detail: Departure Date/Time: ______Return Date/Time: ______

2Please include approximately 200 Thai Baht or 7 USD for banking fees in the remittance. Before making the transfer, please ask the bank to confirm the total transfer charges so as to ensure that the full amount of your accommodation fee +7 USD is deposited in our Thai bank account. In case the full accommodation fee is not received in our account, you will be asked to pay amount outstanding on the day of the conference. You will receive a payment receipt on the day of the conference.

-3- PAYMENT METHODS

 Calculation of total payment: Registration: ______Baht/US$ Accommodation: ______Baht/US$ Total: ______Baht/US$

The registration and accommodation fee can be paid in Thai Baht or US Dollars as determined by the conditions of your category.

Registrations can be paid in cash on arrival or in advance. Please advise the organizers ( att: Mr. Suttilak Soonghangwa) if you intend to pay on arrival. Accommodation booked on this form must be paid in advance.

There are two categories for payment method.  Thai Participants  International Participants

 Thai Participants 1. Via Postal Order or Money Order To Post Office: Phuttha Monthon Pay to: “Research Institute for Language and Culture of Asia”, Mahidol University, Salaya Sub-District, Phuttha Monthon District, Nakhon Pathom 73170 THAILAND

2. Via Gift Cheque or Cashier Cheque Pay to: “Research Institute for Language and Culture of Asia”, Mahidol University, Salaya Sub-District, Phuttha Monthon District, Nakhon Pathom 73170 THAILAND

3. Via Bank Transfer to “Current Account” send to Bank Name The Siam Commercial Bank PCL. Bank Branch Siriraj Account Name Mahidol University Account Number 016-300325-6 SWIFT CODE SICOTHBK

 International Participants 1. Via Bank Draft or Cashier Cheque Pay to: “Research Institute for Language and Culture of Asia”, Mahidol University, Salaya Sub-District, Phuttha Monthon District, Nakhon Pathom 73170 THAILAND

2. Via Bank Transfer to “Saving Account” send to

Bank Name The Siam Commercial Bank PCL. Account Name Research Institute for Language and Culture of Asia Bank Branch Mahidol University Account Number 333-221774-5 SWIFT CODE SICOTHBK

-4-  Submission of Registration Form & Accommodation Form & Payment: The registration form, accommodation form and a proof of payment should be submitted via mail, fax or e-mail to:

Fifth International Conference on Austroasiatic Linguistics Research Institute for Language and Culture of Asia, Mahidol University, Salaya Sub-District, Phuttha Monthon District, Nakhon Pathom 73170 THAILAND Fax: +66 (0) 2800-2332 E-mail: [email protected] Attn: Mr. Suttilak Soonghangwa

Remarks: 1. Please be informed that reserve on or before Tuesday 1st of November, 2011. 3. Please include approximately 200 Thai Baht or 7 USD for banking fees in the remittance. Before making the transfer, please ask the bank to confirm the total transfer charges so as to ensure that the full amount of your registration and accommodation fee + 7 USD is deposited in our Thai bank account. In case the full accommodation fee is not received in our account, you will be asked to pay amount outstanding on the day of the conference. You will receive a payment receipt on the day of the conference. 3. Please note that there will be no refund for cancellation or absence.

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