Please complete and fax or mail this form by February 10, 1997
IFIP WG9.4 WORKING CONFERENCE
Please complete and fax or mail this form by February 10, 1997
Last Name __________________________________ (Prof/Dr/Mr/Mrs/Miss/Ms)
First Name ______________________________________________________
Affiliation _______________________________________________________
Address ________________________________________________________
City ____________________________________ State __________________
Country __________________________________ Zip ___________________
Phone________________ Fax _______________ Email _________________
Date of Arrival _____________________________ Flight No ______________
Date of Departure __________________________ Flight No ______________
Signature ________________________________
US$260 after 20 December 1997
AIT CENTER ROOM RATES AND RESERVATION:
Standard______Single: US$30 ______Double: US$40
Deluxe....______Single: US$40 ______Double: US$45
Please make all payments by bank draft payable to "Asian Institute of Technology" and mail to:
Prof. R. Sadananda
School of Advanced Technologies
AIT, P.O. Box 4, Klong Luang 12120, Pathumthani, Thailand
e-mail: ifip@cs.ait.ac.th Tel:
(66-2) 524-5702
Fax: (66-2) 524-5721
SPECIAL MEAL REQUIREMENTS:
____Vegetarian ____Muslim ____Others (please specify): __________________