Registration Form s9

Registration Form s9

<p> REGISTRATION FORM</p><p>1. Full name (Prof./Dr./Mr./Ms): </p><p>2. Designation/Post:</p><p>3. Working organization and address: </p><p>...... 4. Country:</p><p>5. Contact information:</p><p>Tel: ...... Fax: ...... Email: ...... 6. Accommodation: Do you need assistance with hotel booking?  Yes  No 7. Special dietary requirements, if any:</p><p>8. If you are accompanied by spouse/relatives, please provide information: Name: (Prof./Dr./Mr./Ms): ...... 9. Do you plan to present paper at the conference?  Yes  No Note: The abstract must be submitted by May 2, 2017</p><p>Please feel free to contact us for further information via the following address: Tran Van Thai (Mr.), Program Officer, Division of Education SEAMEO Regional Training Center (SEAMEO RETRAC) 35 Le Thanh Ton St., Dist. 1, Ho Chi Minh City Tel: (+84-8) 3824 5618 (Ext: 126) Fax: (+84-8) 3823 2175 Website: http://www.vnseameo.org/InternationalConference2017/ Email: [email protected]</p>

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