Deadline: 23 Oct

11^th International Symposium on Southeast Asian Water Environment (SEAWE11)
Deadline: 23 Oct. 2014
Accommodation Reservation Form
Please Type or Print in Block Letters, check appropriate boxes and e-mail to ;

Mr. Akihiro KONTA, E-mail: [e-mail]

Travel Industry Consortia inc., #5F, 3-3-6, Kudan-minami, Chiyoda-ku, Tokyo 102-0074, Japan

Given Name: Family Name:

Sex:

Mailing Address:



City: Postal Code: Country:

Tel: + (ext / ) Fax: +

E-mail: Nationality:
Hotels: AIT Conference Center (Symposium Venue)

	Single Room	Double Room
□ New Wings	□ THB 1,700.-	□ THB 1,900.-
□ Main Wings	□ THB 1,200.-	□ THB 1,400.-

*Breakfast and VAT are not included in the above rates. Breakfast THB 250.- per day/per person.
Check in Nov. Check out Nov. Total nights
I will share the room with (use double room)
Credit card information is required for reservation.

Payment should be settled directly with the AIT Conference Center.

For cancellations made after 14 days prior to the reservation date or no shows, a full one night room rate will be charged to your credit card.
Credit Card :

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  AMEX □ Diners □ Master □ VISA □ Others ( )
  

Name of Card Holder (Block Letters):

Card Number: Expire Date / (Month / Year)

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  Please avoid cancellations after the deadline. If necessary, please let us know the reason for cancellation.
  
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  If you have specific questions about accommodation, please ask AITCC directly: [e-mail] and [e-mail]