/ 2012 MAT MTSC Registration Form
Name
Job Title / Country
Company

E-mail

/ /
Tel. No.
Registration / Yes, I would like to register for the MTSC training course, and confirm that I have read the agenda.
* Note: Open to official Moxa distributors only
NOTE: I know that I should study all materials on: http://www.moxa.com/Event/Group/2012/MTSC/MAT/learning.htm
before travelling to the MTSC forum.
This year’s MTSC training will be held at:
Taipei Innovation City Convention Center

2F., No.223, Sec. 3, Beixin Rd., Xindian Dist., New Taipei City 231, Taiwan

MOXA will provide daily transportation between the hotel and the training site
Accommodations / Please book a room for me at the LAKE HOTEL for 3 nights (Jan. 10, 11, 12). I agree to pay room rate shown for my room choice below.
Please book a room for me at the LAKE HOTEL for 4 nights (Jan. 9, 10, 11, 12, ). I agree to pay room rate shown for my room choice below.
Select one of the following room types.
Lake View Single / Appro.
USD 76.
(incl.VAT)
Per day /
Grand View Suite / Appro.
USD 84
(incl.VAT)
Per day /
Executive King / Appro.
USD 92.
(incl.VAT)
Per day /
Executive Twin / Appro.
USD 96.
(incl.VAT)
Per day /
Sweetie Suite / Appro.
USD 108.
(incl.VAT)
Per day /
Please use the “Additional Comments” box below to list special requirements.
Pick-up Service / We will arrange pick-up service for you free of charge from the airport. Please provide us with your flight information.
Yes, I would like MOXA to arrange pick-up service from the airport.
Arrival Flight Information
Flight Number: ______
Arrival Date: ______
Arrival time: ______
Departure Flight Information
Flight Number: ______
Departure Date: ______
Departure Time: ______
No, I do not need pick-up service.
Additional Comments / Thank you for filling out this form. The information you provide will assist us in arranging the course.

Please fill out the registration form and email it to , thank you.