The 9th Southeast Asian Ergonomics Society Conference Office

Faculty of Engineering, ThammasatUniversity, Klongluang, Pathumthani (12120)Thailand

Tel. +66(0)25643001~9 Ext 3093 or 3038 Fax +66(0)25643017

Conference Registration Form

Please print and return by e-mail, air mail or fax.

Conference Date: 21-24 October 2008

Place : The Grand Mercure Fortune Bangkok, THAILAND

1. Participants information

Name:……………………………..……………………………………………………………………………………………………………......

(First name) (Middle name) (Last name)

Title: Prof.  Dr.  Mr.  Ms.  Mrs.  other………………….………..………………………………………………………..

Organization:………………………………………..…………………………………………………………………………………………………….

Address:……………………………………………………………………………………………………………..…………………………………….

City:……………………………… State/Province………….……………………Postal code:……………………Country:…………….………….

Telephone:………………………………..….……….Fax:……………………………..E-mail:…….……………………….……………………..…

2. Conference Fee

Conference fees include a conference proceeding and materials, lunch, coffee breaks, conference banquet and all activities during the conference for both professionals and students. For other people are coming with you and would like to join reception event, lunch and conference banquet, please ask for extra registration at the registration desk.

Participant / Before Sep 20, 2008 / After Sep 20, 2008 / Registration
Amount
Late (Sep 21- Oct 20) / Onsite
Author and Co-author / US$ 395 / US$ 445 / US$ 465 / ______
Full-time student / US$ 200 / US$ 250 / US$ 270 / ______
Non-author / US$ 415 / US$ 465 / US$ 485 / ______
SEAES member / US$ 350 / US$ 400 / US$ 420 / ______
IEA member / US$ 375 / US$ 425 / US$ 445 / ______
Note:
1. Each full-time student is required to submit an official letter of status proof from his/her university or advisor at the time of registration.
2. The payment should be performed to complete the early registration on or before September 20, 2008.
3. Each corresponding author is required an additional registration fee when more than two papers are accepted for presentations.
4. An official email from IEA or SEAES office should be presented at the time of registration.

3. Title of Paper: (Maximum of two papers of which the registered participant is an author or co-author)

4. Registration for the pre-conference special event

Industrial and Thai culture field trip, as supported by Thai industries, will be hold on October 21, 2008. This special event will bring researchers and practitioners to exchange their knowledge and experiences on ergonomics inside an industrial plant at Ayuthaya province during the morning period and Thai culture arts and crafts centers in the afternoon. All participants will be invited for this special event and welcome reception without any additional fee. Please inform if you would like to join this event within September 20, 2008.

Yes, I would like to join the event No, I will not join the event

5. Payment: Total amount: US$...... ……………Date………/……………./2008 Time….……………… (Bank transaction information)

Bank draft (in US$) (Payable to SEAES 2008)Note: Drawn on at any bank in Bangkok is preferred, if possible

Bank transfer (in US$) :

Bank Name: Kasikornbank Branch: Klong-luang Swift Code:KASITHBK Routing No.: 021000021

A/C Type: Savings A/C Name: SEAES 2008A/C No.: 178-2-08135-5

Bank Address: Kasikorn Bank Public Company Limited, 1 Kasikorn Lane Ratburana Road, Bangkok THAILAND (10140)

Cancellation Policy: For cancellations notified on or before September 25, 2008, all registration fees less 50% (to cover administration costs) shall be

refunded. After September 25, 2008, there shall be no refunds.

Fax or e-mail (scanned) registration documents (registration form, photocopy of student ID card (if required), and photocopy of bank draftor bank transfer slip) on or before September 20, 2008 for early-bird registration. For the bank draft, send via air mail to: Naris Charoenporn, Department of Industrial Engineering, Faculty of Engineering, ThammasatUniversity, Pathumthani12121, Thailand. Telephone: +66-2-564-3001~9 ext. 3093 or 3038 Fax: +66-2-564-3017. E-mail: .

Signature:______Date:_____/______/2008

SEAES 2008 will be organized by ThammasatUniversity (Faculty of Engineering, Faculty of Public Health, and Faculty of Allied Health Sciences) and Ergonomics Society of Thailand (EST). Any inquiries about the SEAES 2008 can be sent to the conference Secretariat at .