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<title>Bangkok Meeting - Online Registration</title>


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<table><tr><td valign="middle"><img src="/img/tit02_1.gif" width="37" height="44"></td>
<td valign="middle"><font class="tit">Pre-Registration for APTLD Meeting</font></td><td valign="middle"><img src="/img/tit02_2.gif" width="196" height="44"></td></tr></table>


<p>Bangkok Members and Board Meeting </p>
<p>13/14 November 2006</p>

<p>Please use this form to register your attendance at APTLD's next meeting. The Secretariat will contact you after you register, to confirm your registration. </p>
     <p>&nbsp;</p>
     <p>If you are interested in attending this meeting but not yet an APTLD Member, please use this same form.  We will contact you to confirm your interest.</p>
     <p>&nbsp;</p>
     <p>If you plan to stay at the Amari Watergate Hotel, you will need to contact the hotel direct to make your room bookings. Please make bookings directly with the hotel on <b><a href="mailto:sales@watergate.amari.com">sales@watergate.amari.com</a></b> using the <b><a href="ReservationForm.doc">form provided</a></b>.</p>
 
     
     
<h3>Registration Details</h3>

<table><tr>
<td align="right">Title: </td>
   <td colspan=3 align="left"><INPUT TYPE="TEXT" SIZE="30" NAME="Title"></td>
 </tr>
 <tr>
  <td align="right">Name:</td>
  <td colspan=3 align="left">
  <INPUT TYPE="TEXT" SIZE="30" NAME="name">
  </td>
 </tr>
 <tr>
  <td align="right">Organisation:</td>
  <td colspan=3 align="left">
  <INPUT TYPE="TEXT" SIZE="50" NAME="org">
  </td>
 </tr>
 <tr>
  <td align="right">Country:</td>
  <td colspan=3 align="left">
 <INPUT TYPE="TEXT" SIZE="15" NAME="country">
  </td>
 </tr>
 <tr>
   <td align="right">Email Address:</td>
   <td colspan=3 align="left">
   <INPUT TYPE="TEXT" SIZE="30" NAME="email">
  </td>
 </tr>
 <tr>
  <td align="right">Phone number:</td>
  <td colspan=3 align="left">
<INPUT TYPE="TEXT" SIZE="30" NAME="phone">
  </td>
 </tr>
 <tr>
   <td align="right">Arrival Details<br>(Please let us know your arrival date/time)</td>
   <td colspan=3 align="left"><TEXTAREA ROWS="8" COLUMNS="60" NAME="details">  </textarea>
     </td>
 </tr>


</table>



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<table border=0 cellpadding=0

              <tr> 
                <td valign="top"><img src="/img/icon0.gif" name="Image12" width="12" height="11" border="0" id="Image1"><font class="button"><a href="BangkokNotice.html">Members and Board Meeting Agenda</a> (DRAFT)</font></a></td>
              </tr>              <tr> 
                <td valign="top"><img src="/img/icon0.gif" name="Image12" width="12" height="11" border="0" id="Image1"><font class="button">Back to <a href="index.htm">meeting home</a></font></td>
              </tr>              <tr> 
                <td valign="top"><img src="/img/icon0.gif" name="Image12" width="12" height="11" border="0" id="Image1"><font class="button">For more information, please contact <a href="mailto:sec@aptld.org">sec@aptld.org</a></font></td>
              </tr>              <tr> 
                <td valign="top"><img src="/img/icon0.gif" name="Image12" width="12" height="11" border="0" id="Image1"><font class="button">Venue: The Amari Watergate Hotel, Bangkok</font></td>
              </tr>



 
</table>

</form>