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  Please fill in completely and accurately, to be used when issuing certificate.
 
Package
  Package Course Registration Fee (VAT included)
BAHT USD
A  Coursework (Thailand) 69,000  2,600 
B  Coursework (CASRIP) 107,000  3,600 
C  Full Package: Coursework (Thailand and CASRIP) 149,500  5,500 
Details of course participant
Country:  *
Prefix:  * Sex:   Male    Female *
ชื่อ (ไทย):  * สกุล (ไทย):*:  *
First Name:  * Last Name:  *
Job title:   * E-mail:  *
Mobile number:  Alternate E-mail: 
Organization Details
Organization type: *  
Organization classification: *
Organization Name:  *
Address:  *
City/Suburb:  *
State/Province:  *
Post Code: *
Telephone number:
Fax number: