REGISTRATION FORM

(Conference participant)

Mekong-2-Rio: International Conference on TransboundaryRiver Basin Management

Mövenpick Resort and SpaKaronBeach Phuket

Phuket, Thailand, 1-4 May 2012

There is no fee for participation.

We kindly appreciate your cooperation in filling out the form below to help us better organize your trip/stay and your active participation in the conference. Registration is based on a first come first served basis and after submission of the registration, if space is available, you will receive a confirmation from the MRCS.

(Please filland details in the blocks below and complete one form for each participant)

PART A

1.Full name of participant(as shown on your passport):

Salutation: MrMrsMsDr.Prof.Other

First name:

Last name:

2.Job title/function:

3.Name of organization/company:

4.Address(Street name):

(City):

(Postcode) :

(Country):

5.Telephone (Office):

6.Telephone(Mobile):

7.Fax:

8.E-mail:

9.Are you funded by MRC?: Yes No

10.Professional experiences/ interests (briefly describe):

PART B

1.Your arrival and departure information

1.1 Arrival information:
Mode of transportation / Flight / Car / Bus
Transportation details
(e.g., airline, flight no.) / / /
Arrival date / 30 April / 1 May / 2 May / 3 May / Other:
Arrival time / / / / /
Airport transfer needed / Yes / No
1.2 Departure information:
Mode of transportation / Flight / Car / Bus
Transportation details
(e.g., airline, flight no.) / / /
Departure date / 1May / 2 May / 3 May / 4 May / Other:
Departure time / / / / /
Airport transfer needed / Yes / No

Remarks:a)Airport transfer services only between the airport and the hotels, i.e., MövenpickResort & SpaKaronBeach Phuket, Woraburi Phuket Resort & Spa and KaronSea Sands Resort & Spa.

2.Do you need assistance with a hotel reservation: Yes No

2.1If yes, please specify your hotel & room type preference listed below:

Hotel options / Room types / Cost/night
(Baht)
1. MövenpickResort & SpaKaronBeach Phuket (Meeting venue)
Address: 509 Patak Road, KaronBeach,
Phuket 83100 Thailand
Tel: +66 (0) 76 396 139
Fax: +66 (0) 76 396 144
Website:
Services: a) Included American breakfast
b) Free Wifi / Deluxe single bed
Deluxe twin bed
Garden villa
Deluxe garden villa
Plunge pool villa
Penthouse plunge pool villa
2 bedroom family suite
Residence / 2,800
2,800
5,000
6,000
7,000
8,500
13,000
13,000
Hotel options / Room types / Cost/night
(Baht)
RamadaPhuketSouthSea
Next to the conference venue in a walking distance. For more information please visited / Superior single
Superior double / 2,200
Princess Sea View Resort and Spa
About 1 km from the conference venue, the hotel will provide shutter buses to Karon beach. TNMC will also provide transportation to/from the conference venue.For more information please visited / Deluxe single
Deluxe double / 1,200

2.2If you plan to share the room with another participant, kindly indicate his/her name below to avoid double booking.

Mr/Ms

Remarks:a)For the participants funded by MRC, you will receive Daily Subsistence Allowance (DSA) based on MRC policy which is USD 130/day based on February rate. Costs for lunch and dinner during the conference will be deducted from this rate. Cost of accommodation is included in this rate and the participants are required to pay for their room directly to the hotel. For reimbursement the followings are required:

- Receipt for airfare

- Boarding passes

- Receipts or related documents for other travel related costs

b)Distance from PhuketInternationalAirport to each hotel is about 45 kms. or 1 hour by car.

c)The Conference will not reimburse individual airport transfer costs

d)Distance from each Hotel to KaronBeach about 20 meters

e)1 US dollar = 30 baht approximately

3.Do you have any dietary needs? :Yes No

If yes, please explain (e.g. vegetarian only) :

4.Are you interested in participating in a field excursion? :Yes No

If yes, which option you prefer:

AndamanSea Crusing 1 : PhiPhiIsland + KhaiIsland

AndamanSea Crusing 2:Phang-NgaIsland + MuslimVillage

*There will be a fee for field excursion amount USD 50/person (Transportation + lunch)

Remarks:The field trip will occur on Day 4 (4 May 2012). The registration form for the field excursion with detailed information will be sent to those who have registered.

......

For more information please contact:

Mr. Julien Simery or Ms. Palamy Soukhathammavong

MekongRiver Commission Secretariat

Vientiane, Lao PDR

Tel: +856 21 263 263 Ext: 4070

Fax: + 856 21 263 264

Email:

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