Attendance Form

Meeting

Meeting Name: *

9th Meeting of APT Wireless Forum

APT Meeting on e-Applications/ e-Government

APT Cybersecurity Forum

12th SATRC Meeting

Personal Information

Title: *

Miss

Mrs

First Name: *

Last Name: *

Administration/Organization: *

Present Post (Title): *

Business Address: *

Country: *

Phone No.: *

Fax No.:

E-mail address: *

Are you representing your Country’s Administration?: *

Yes

If Yes what’s your position in delegation:

Head of Delegation (HoD)

Alternate Hod

Delegate

Membership Status (Please tick which is appropriate for your membership status)

Passport Information for Visa: (Provide only if you need visa supporting letter)

Passport No.:

Date of Issue:

Expiry Date:

Place of Issue:

Date of Birth:

Place of Birth:

Place of Getting Visa:

Flight Information

Arrival Flight (Flight No./ Date/ Time):

Departure Flight (Flight No./ Date/ Time):

Hotel Accomodation

Please make a reservation: *

Yes

Hotel Name/ Room Type:

Check In Date:

Check Out Date:

Payment Method:

APT Fellowship

Cash

Credit Card

Last updated on 07/09/2010

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Attendance Form