12th Sakyadhita Bangkok 2011 Registration Form
Questions marked by * are required.
1. Date: *
2. Email: *
3. Surname/family name *
4. Title
5. Given name(s) *
6. Name on your Passport *
7. Other names, include: Surname, Title, Given name
8. Passport Number *
9. Country of Passport Issue *
10. Address *
11. Country of Residence *
12. Phone/Fax
13. TYPE OF REGISTRATION: Your registration fee includes registration fee, meals, airport pickup and local transportation.
14. LODGING 1: If you have selected Registration Only, we can reserve your lodging. Select one:
15. A third hotel option is the Siam Society Hotel and Resort. You must book directly, online at: http://www.siamsocietyhotel.com
  • Yes, I will make my own reservations on line for this hotel.
  • Not applicable.
16. LODGING 2: If you selected "Registration with Simple Accommodation," select type:
17. If you have selected a double or shared room, name of the person you wish to share with.
18. MEALS: June 12-18. All vegetarian meals. Please select the meals you want.
  • Breakfast, lunch, tea and evening meal
  • Breakfast, lunch, and tea
19. TRANSFERS are available from airport to lodging on June 11 only. Select one.
20. TEMPLE TOUR to Ayutthaya on June 19 (US$40). Select one.
21. SPONSORSHIPS: I would like to help sponsor a woman from a developing country with a contribution of:
22. Other amount I will contribute:
23. With my contribution, please assist a nun or laywoman from the following country or tradition:
24. TOTAL amount of my payment: including registration, temple tour and additional contribution. *
25. Method of payment by check or wire.
26. Make payment electronially. Use PayPal or debit/credit card at: www.Sakyadhita.org donate button.
27. If paying via the Donate button on sakyadhita.org, I will state clearly on the PayPal form for whom the payment is being made.
  • Yes, I won't forget.
  • Not applicable
28. I will pay online for the person whose name is on the top of this form. My name and address are:
29. Talents or ideas to share: