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Registration form |
The 2nd Asia Pacific
Conference in Malaysia organized
jointly by
Union of Risk Management for Preventive Medicine
(Please
type. Fax till September 15, 2005)
to be held in Kota Bharu, Malaysia, October 1-3, 2005.
Male □ Female
□
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▲Surname
▲ Town
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▲First name
▲Country
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▲Title
▲ Telephone (country code, are
code, number)
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▲Organization ▲Fax
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▲Mailing address
▲E-mail
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▲Postal code ▲Please indicate the name of accompanying persons
A. REGISTRATION
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Please
note that the registration is not valid until the payment has been received.
DELEGATE
MEMBER, OECD country*
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US$/PERSON |
No. of
persons |
US$/total |
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By April 28, 2005 |
200.00 |
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After May 1, 2005 |
300.00 |
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DELEGATE MEMBER,
non-OECD country**
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US$/PERSON |
No. of
persons |
US$/total |
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By April 28 2005 |
150.00 |
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After May 1, 2005 |
200.00 |
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Non URMPM MEMBER
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US$/person |
No. of
persons |
US$/total |
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By April 28, 2005 |
300.00 |
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After May 1, 2005 |
450.00 |
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GRADUATE STUDENT,
OECD country***
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US$/person |
No. of
persons |
US$/total |
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By April 28, 2005 |
100.00 |
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After May 1, 2005 |
150.00 |
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GRADUATE STUDENT,
non-OECD country***
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US$/person |
No. of
persons |
US$/total |
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By April 28, 2005 |
50.00 |
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After May 1, 2005 |
80.00 |
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Total 1) |
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*) OECD:
Organization for Economic Co-operation and Development. Confirm the OECD member countries on
**)
All of membership fees from the non-OECD countries are completely supported by
JSRMPM. It means those participants need not to pay this registration fee.
***) To quality for student you must be
under 25 and send us a copy of valid student card or provide an official letter
from your institution confirming evidence of student status.
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B. SOCIAL PROGRAMME |
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Social Programme |
US$/person |
No of
persons |
US$/total |
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Banquet on October 1 at 19:00 |
80.00 |
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Total 2) |
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GRAND
TOTAL (1+2)
C. OPTIONAL
TOURS
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On the following homepages of major tourist companies for
downtown and greater Tokyo areas and a whole of Japan, you can find and
register your tour by yourself.
Your charge has to be paid to each tourist company directly by yourself,
too.
1) JAPAN TRAVEL BUREAU (JRB)
Sunrise: www.jtb.co.jp/sunrise
2) HATOBUS: www.hatobus.co.jp/english/index.html
3) IACA
TRAVEL: http://www.iace-usa.com/html/english.html
4) NIPPON TRAVEL AGENCY: http://www.nta.co.jp/english/index.htm
5) KINKI NIPPON TOURIST:
http://www.knt.co.jp/kokusai/top.htm
6) TONICHI TRAVEL SERVICE: http://www.tonichi.co.jp/japan/index.html
c.f.) JTB and HATOBUS have English
guide tours. You can confirm other
company by yourself, here.
D. ACCOMODATION
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The Conference place locates
on Shinjuku area
The above tourist websites are
also available for hotel accommodation on their English homepages.
For discount hotels, consult http://www.e-hoteljapan.com/.
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E.
PAYMENT |
Please pay at the time of
registration desk during the conference days.
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F.
ABSTRACT AND PROCEEDINGS |
Abstract submission: YES □ NO □
Proceedings paper
submission: YES □
NO □
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Please fill all in this
Registration Form, and fax them to Registration Office shown
in the below. After this
registration, the Abstract Submission Form should be e-mailed to
the corresponding Registration Office by September 15, 2005. The e-mail address appears in the
Abstract Submission Form.
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Please
return this FORM, APPLICATION FOR REMITTANCE and STATEMENT OF REMITTANCE by
fax to Registration Office: Prof.
Rusli B. Nordin, University
of Science Malaysia Fax:
609 (765)9305
(609 is a country code) |