PAYMENT FORM (Individual)

ASPAC CONFERENCE 2009

PAYMENT FORM (Individual)

Name ______

Institution______

Address______

______Country ______

Phone ______Fax ______

E-mail ______

Amount Early Registration (By January 31, 2009)
US $180 for ASPAC Members
US $280 for Non ASPAC Members

Normal Registration (After January 31, 2009)
US $220 for ASPAC Members
US $320 for Non ASPAC Members

Note:

- For payment by bank transfer, please pay to ASPAC account in full amount.

- For payment by credit card on-line, please add US$10.- to your total amount due,

to cover the Bank fee for each transaction.

Payment Method
By electronic funds transfers to:

Swift Code: AYUDTHBK

Bank: Bank of Ayudhya Public Company Limited Bank Code:25

Account Name: NSM-ASPAC Currency: USD

Account No. : 292-5-00001-9

Branch: Main Office, Bangkok Thailand
Address: 1222 Rama III Road, Bang Phongphang, Yannawa, Bangkok 10120

Thailand.

Tel. (662) 0-2296-4387, 0-2683-1000 Fax (662) 0-2683-1304

By Credit Card On-Line (Visa or MasterCard), please go to:

(see FOR CONFERENCE 2009), User name and password to log-in will be given upon request, please send E-mail directly to: or fax your request to: +66 2577 9990

Authorized Signature ______ Date ______

Remark: We do not accept cash or cheque.

For 2009 ASPAC Conference Payment
Please Contact, post, E-mail or fax this form to:
Thanakorn Palachai, ASPAC Treasurer
Vice President, National Science Museum, Thailand
Technopolis, Klong 5, Klong Luang, Pathum Thani 12120, THAILAND
E-mail to: and CC: to
Phone +66 2577 9999 ext. 1850-2 Fax: +66 2577 9990

Correspondent Banks

CURRENCY / BANK / CITY / SWIFT CODE
GBP
(POUND STERLING) /
HSBC BANK PLC (MIDLAND BANK PLC)
BARCLAYS BANK PLC
/
LONDON
LONDON /
MIDL GB 22
BARC GB 22
USD
(US DOLLAR) /
ABN AMRO BANK N.V.
AMERICAN EXPRESS BANK LTD.
BANK OF NEW YORK
CITIBANK N.A.
DEUTSCHE BANK TRUST CO., AMERICAS
HSBC BANK USA (MARINE MIDLAND BANK NA)
WACHOVIA BANK NA
WACHOVIA BANK
JPMORGAN CHASE BANK
STANDARD CHARTERED BANK
UNION BANK SWITZERLAND AG
/
NEW YORK
NEW YORK
NEW YORK
NEW YORK
NEW YORK
NEW YORK
NEW YORK
PHILADELPHIA
NEW YORK
NEW YORK
ZURICH /
ABNA US 33
AEIB US 33
IRVT US 33
CITI US 33
BKTR US 33
MRMD US 33
PNBP US 3N NYC
PNBP US 3N PHL
CHAS US 33
SCBL US 33
UBSW CH ZH 80A
HKD
(HONGKONG DOLLAR) /
HONGKONG & SHANGHAI BKG. CORP. LTD.
/
HONGKONG /
HSBC HK HH HKH
HF
(SWISS FRANC) /
UNION BANK SWITZERLAND AG
BANQUE CANTONALE DE GENEVE
/
ZURICH
GENEVE /
UBSW CH ZH 80A
BCGE CH GG
AUD
(AUSTRALIAN DOLLAR) /
AUSTRALIA & NEW ZEALAND BKG GROUP LTD
/
MELBOURNE /
ANZB AU 3M
JPY
(JAPANIES YEN) /
WACHOVIA BANK NA
SUMITOMO MITSUI BANKING CORP.
AMERICAN EXPRESS BANK
/
TOKYO
TOKYO
TOKYO
/
PNBP JP JX
SMBC JP JT
AEIB JP JX
EUR
(EURO DOLLAR) /
AMERICAN EXPRESS BANK
ABN AMRO BANK NV
BANCA NAZIONALE DEL LAVORO
BAYERISCHE HYPO-UND VEREINSBANK AG
NATEXIS BANQUES POPULAIRES
/
FRANKFURT
AMSTERDAM
ROMA
MUENCHEN
PARIS /
AEIB DE FX
ABNA NL 2A
BNLI IT RR
HYVE DE MM
CDBP FR PP
SGD
(SINGAPORE DOLLAR) /
UNITED OVERSEAS BANK LTD
STANDARD CHARTERED BANK
/
SINGAPORE
SINGAPORE /
UOVB SG SG
SCBL SG SG

Remarks: The Account number and related documents will be cancelled, if the Bank has not received the initial deposit within 1 month.