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Registration Form
IFHNOS World Tour 2008, Imperial Queen’s Park Hotel, Bangkok, Thailand,
October 23-25, 2008

Pakpoom Supiyaphun, MD
Department of Otolaryngology
Faculty of Medicine, Chulalongkorn University,
Bangkok 10330, Thailand
E-mail : chula_ent@yahoo.com ,cu_ent@hotmail.com
Surname :
*
First Name :
*
Title (circle) : Prof. Dr. Mr. Ms.
Institution :
Address :
Country :
Tel :
Fax :
Tlx:
E-mail address :
 *
 
Registration Fees
  Participants:
US$ 260 (Before August 1, 2008)
US$ 360 (After August 1, 2008)
  Students, Residents and Fellow:
  US$ 160 (Before August 1, 2008)
  US$ 260 (After August 1, 2008)
 
Participants from guest countries including Kingdom of Cambodia, Laos, Myanmar, Thailand are free of charge
Payment
Bank Draft or certified cheque
No :
Date :
Bank :
Payable to: The Royal College of Otolaryngologists-Head and Neck Surgeons of thailand
Credit card

 
Agreement:
To confirm your reservation as per above details and to authorize charges in case the cardholder could not follow the above terms and
conditions, please sign to acknowledge your acceptance of applying cancellation, no-show and change penalty charges to your credit card.
 
Fill in the numbers and letters you see on the picture above :
*


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CONTENTS
   
Message from President
Organizing Committee
Touring Faculty
Regional Experts
Jatin Shah
William Wei
Jean-Louis Lefebvre
Kie-Kian Ang
Patrick Gullane
Christopher O’Brien
Arlene Forastiere
Scientific Program
Conference & Hotel Information
Registration Form
HOTEL : THE IMPERIAL QUEEN’S PARK HOTEL
HOTEL : THE IMPERIAL TARA HOTEL
Hotel Reservation Form: THE IMPERIAL QUEEN’S PARK HOTEL
Hotel Reservation Form: THE IMPERIAL TARA HOTEL
General Information
Imperial Queen’s Park Hotel and Imperial Tara Hotel Map