| First Name * Middle Name Last Name * | |||
| Gender *: | Male Female | Age * | |
| Address | Citizenship* | ||
| Telephone * | |||
| Telefax | |||
| E-Mail * | |||
| Club Name * | |||
| Guest | Invited by | Region *: | |
| Non-member | Introduced by | Area *: | |
| Name Pref. on Tag : * | |||
| Current appointment or office:* | IEO ICM PIP ISD IP AP RD DG BF Delegate Club President Club Member | ||
| Others: (Please specify) | |||
| Is this the first time you attend a Y's Men's International Conference? | Yes No | ||
| Language Spoken: * | English Japanese Korean Mandarin Others | ||
| Spouse's Name Menette/spouse | Name preferred on Tag | Member of Y's Menette Club Yes No | ||
| Y's Ling | Age | Male Female | ||
| Y's Ling | Age | Male Female |
| Special for Early Registration Package : 3 days 2 nights at Montien Riverside Hotel | |||
| Details | Rates per Person | ||
|---|---|---|---|
| 16 May 2007 - On site | |||
| Registration fee 2 Dinners, 1 Lunch, 3 Coffee Breaks | USD 250 | ||
| Room charge 2 nights, Twin sharing basis | USD 90 | ||
| Room type | Superior available 100 rooms | ||
| American breakfast | 12.5 x 2 | ||
| Transfer from airport Round trip | USD 30 | ||
| Total NET Twin Sharing | NET USD 395 | ||
| Single supplement | + USD 90 | ||
| Total NET Single supplement | USD 485 | ||
| Special Request for Extra Night (USD 110 per Room per Night) No. of Rooms No. of Nights Before After Seminar | |||
| (By 15 May 2007) USD 220 | On-site Registration (after 16 May 2007 to on site) USD 250 |
| Y's Men Member | person |
| Y's Men Menette | person |
| Y's Ling and others | person |
| Meal: Please indicate special dietary needs: | Vegetarian Others |
| Early Registration | (By 15 Jan 2007 ) USD 180 | (By 15 May 2007) USD 220 | On-site Registration (after 16 May 2007 to on site) USD 250 |
| Recommended Tour | Duration | Fee per Person(USD) | Date | No. of Attendees |
|---|---|---|---|---|
| Damnernsaduak Floating Market & Crocodiles+Elephant Show & Rose Garden | Full Day | 60 |
| |
| Ayutthaya Tour by Boat | Full Day | 46 |
|
| Package Tour Outside Bangkok | 3 Star-Hotel | 4 Star-Hotel | 5 Star-Hotel |
|---|---|---|---|
| Pattaya (3 days 2 nights) Pre 08-10/08/2007 or Post 12-14/08/2007 | USD 320 per person | USD 385 per person | |
| Pattaya (3 days 2 nights Single) Pre 08-10/08/2007 or Post 12-14/08/2007 | USD 400 per person | USD 485 per person | |
|
Chiang Mai-Chiang Rai High Light (4 days 3 nights) Pre 07-10/08/2007 or Post 12-15/08/2007 | USD 500 per person | USD 640 per person | USD 1,135 per person |
|
Chiang Mai-Chiang Rai High Light (4 days 3 nights Single) Pre 07-10/08/2007 or Post 12-15/08/2007 | USD 605 per person | USD 850 per person | USD 1,805 per person |
|
Phuket-Phang Nga-Phi Phi Island-Phuket Fantasy (3 days 2 nights) Pre 08-10/08/2007 or Post 12-14/08/2007 | USD 485 per person | USD 520 per person | USD 650 per person |
|
Phuket-Phang Nga-Phi Phi Island-Phuket Fantasy - Single (3 days 2 nights ) Pre 08-10/08/2007 or Post 12-14/08/2007 | USD 625 per person | USD 695 per person |
| Golf Course | Date | Golfer | Weekday | Weekend | Caddy Fee | Golf Cart | Remark (MIN4PAX) |
|---|---|---|---|---|---|---|---|
| Rose Garden |
| USD 42 | USD 59 | USD 8 | USD 15 | (W/D=MAX5PAX, W/E=MAX4PAX) | |
| Royal Gems Lodge 2000 |
| USD 71 | USD 105 | USD 7 | USD 17 | Package2D1N +ABF WITH 18 HOLES | |
| Arrival date | | Time | e.g. 20:05 | Airline/Flight No. | |
| Departure date | | Time | e.g. 20:05 | Airline/Flight No. |