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Payment Form



  Personal Profile
   
   Prefix:
  Mr. Mrs. Miss Other
 
   
   Name-family name:*
 
   
  Type of Paper:*
 
   
  Types of Registration :
  Presenter (3,000 ฿) Participant (2,000 ฿) Student (1,000 ฿) << Early Bird (by May 30)
   
  Presenter (3,500 ฿) Participant (2,500 ฿) Student (1,500 ฿) << Standard (after May 30)
   
  Payment
   
  Total Amount :* >>(1000)
 
   
  Payment Date :* >>(20/04/2014)
 
   
  Payment Time :* >>(12.15)
 
   
  Pay-in slip:* >>(.jpg , .png ,.pdf)
 
   
  Security Code
   
  + = (Are you human, or spambot?)
   
   
   

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