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Personal Information |
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Name: xxxxxxxxxx
Prefix: xxxxxxxxxx
First Name: xxxxxxxxxx
Middle Name: xxxxxxxxxx
Family Name: xxxxxxxxxx
Date of Birth: xx - xx - xx
Passport Detail:
Passport Number: xxxxxxxxxx
Nationality: xxxxxxxxxx
Date of Expiry: xx - xx - xx
Address 1: xxxxxxxxxx xxxxxxxxxx
Address 2: xxxxxxxxxx xxxxxxxxxx
City: xxxxxxxxxx
Province/State: xxxxxxxxxx
Zip Code: xxxxxxxxxx
Country: xxxxxxxxxx |
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| Emergency Contact Person |
Last Name: xxxxxxxxxx
Name: xxxxxxxxxx
Fax: xxxxxxxxxx
Phone: xxxxxxxxxx
Email: xxxxxxxxxx
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| Other important information |
| Special Requirements: |
xxxxxxxxxx xxxxxxxxxx xxxxxxxxxx xxxxxxxxxx
xxxxxxxxxx xxxxxxxxxx xxxxxxxxxx xxxxxxxxxx
xxxxxxxxxx xxxxxxxxxx xxxxxxxxxx xxxxxxxxxx
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Registration Details |
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| Details |
Price per Unit |
Subtotal |
| IFSCC Member |
850.00 |
850.00 |
| Accompany person |
1802.00 |
1802.00 |
| Photobiology Course |
800.00 |
800.00 |
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Other Details |
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| Details |
Price per Unit |
Subtotal |
| The Royal Grand Palace and Emerald Buddha Temple |
0.00 |
0.00 |
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| Accepted Credit Cards |
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Paypal |
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MasterCard |
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Visa |
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| Deadlines |
| Early Registration |
May 30, 2011 |
| Late Registration |
Oct 15, 2011 |
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