reg_hk_eng

¡§Embracing New Challenges : Women in Action¡¨
19th ¡V 22nd December 2003
Venue: Hong Kong Baptist University
| Forum
  Registration Form | 
 
Please TYPE or PRINT in BLOCK LETTERS and return this form to the Forum Secretariat:
Room 09, 17/F., Prosper Commercial
Building, 9 Yin Chong Street, Kln, Hong Kong
Tel: (852) 2374 1268  Fax: (852) 2396 6465  E-mail:  
info_5eawf@genesismarketing.com.hk 
Website: www.eawf.org
 
| Personal Information | 
Please type or print
in block letters and ¡§¡Ô¡¨ where appropriate
| Surname: Mr / Ms
  ______________________________ | Given Name: 
  _____________________________________________ | ||||
| Position: 
  ______________________________________________________________________________________________ | |||||
| Organization: 
  ___________________________________________________________________________________________ | |||||
| Badge Name, Title and Organization: (Name exactly as you wish it to be
  on your name badge; limit to 50 characters.) | |||||
| ______________________________________________________________________________________________________ | |||||
| Mailing Address:  | ______________________________________________________________________________________ 
   | ||||
| Tel: _________________________ | Fax: ________________________ | E-mail: 
  ____________________________________ | |||
| Emergency Phone Number: 
  ____________________ | Contact Name: 
  ____________________________________________ | ||||
 
| Areas of concern | 
Please check the boxes to indicate the programs you would like to join.
| 19/12 (Fri) | 20/12 (Sat) | 21/12 (Sun) | 22/12 (Mon) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Other Services Requested | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Travel 
  with wheelchair?  | ¨      No | ¨      Yes |   | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Rehabilitation bus service required? | ¨     
  No | ¨     
  Yes | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Simultaneous interpretation service required: | ¨     
  Cantonese | ¨     
  Putonghua | ¨     
  English | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Other request, 
  please specify: 
  ______________________________________________________________________________ | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
 
| Local tour Arrangement | |||
| Tour & NGO Visit | Tour AWomen & Housing in HK Sight visit to public & private
  housing estate | Tour BWomen & Food in HK  ¡§Food & Culture¡¨ | Tour CWomen & Consumption in HK Experience the glamour of shopping paradise | 
| Date | 4:30-8:30 p.m.  21/12/2003 (Sunday) | 2:30-6:30 p.m., 22/12/2003 (Monday) | |
| Tour Fee | HK$80 (Afternoon tea set inclusive) | HK$60 (Afternoon tea set inclusive) | HK$60 | 
| Description | Visiting different types of housing in
  Hong Kong to give you a touch of lives of Hong Kong women of different
  socio-economic backgrounds.   Scenic spot: Tai Hang Tung Public Housing 
  Estate, Kowloon Tong residential area, afternoon tea at Yau Yat Chuen. NGO visit to Hong Kong Young Women¡¦s
  Christian Association | Preparing meals for family members is a
  major task of women. Sightseeing several scenic spots give you some clues of
  the changing roles of Hong Kong women.   Scenic spot: ¡§Da Pai Dang¡¨, Sham Shui Po 
  Wet Market, Supermarket & Foodcourt at Olympic City   NGO visit to Hong Kong Federation of Women¡¦s Centre | Visiting different types of shopping areas
  helps you to understand consumption styles of marked contrast. You may do
  some shopping as well.     Scenic spot: Tsim Sha Tsui, ¡§Ladies¡¦ Market     NGO visit to Hong Kong Women Worker¡¦s 
  Association | 
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| Payment Declaration | |||
| I would like to settle: | ¨     
  Registration 
  Fee                 
    HK$   250.00;  (Registration
  fee covers forum materials and coffee breaks.) ¨     
  Welcome 
  Reception Fee       
  HK$   120.00; ¨     
  Local Tour 
  Fee ¡V Tour A        HK$    80.00; ¨     
  Local Tour 
  Fee ¡V Tour B        HK$    60.00; ¨     
  Local Tour 
  Fee ¡V Tour C        HK$    60.00; | ||
| in a total of      HK$ 
  _____________ by: |   | ||
| o      
  Visa | o      
  MasterCard | ||
|   Card Number: 
  _______________________________________________________           Expiry 
  Date (MM/YY): _____________   Print Cardholder¡¦s 
  Name: 
  ________________________________________________________________________________     Cardholder¡¦s 
  Signature (DO NOT PRINT): 
  ___________________________________         Date: 
  __________________________ ¡@ I hereby authorize 
  Forum Secretariat to debit my account for the above-mentioned amount. | |||
|   o       Cheque (# __________________ ).   o       Directly Transfer to Hang Seng Bank Limited
  (Account Number: 257-148585-001). | |||
 
| invoice (Please provide the
  requested information for the person and organization to be invoiced.) | |||||
| Surname: Mr / Ms 
  ____________________________ | Given Name: 
  _______________________________________________ | ||||
| Organization: 
  ______________________________________________________________ | Position: ___________________ | ||||
| Mailing Address:  | ________________________________________________________________________________________ 
   | ||||
| Tel: _______________________ | Fax: _________________________ | E-mail: 
  _____________________________________ | |||
 
IMPORTANT NOTES:
1.        
ONE registration form is for ONE person only.  Please use separate form if more than one person register 
for the Forum.  Photocopying of 
this form is acceptable.
2.        
Registration forms received without registration fees paid will not be 
processed.  Please do not send 
cash.
3.        
The Forum program is subject to change without prior notice.  In the unlikely event of cancellation 
of the Forum, the only liability of the organizing committee is to refund all 
the fees paid.
4.        
Refunds for cancellations of registration will be made subject to the 
following deadline and charges after the Forum:
        
On or before Sep 30 2003                                         Full 
Refund.
        
Between Oct 1 and Nov 30 2003                                
Will 
be given a 50% refund.
        
After Nov 30 2003                                                   No 
Refund.
        
All cancellations must be 
made in writing by mail, fax or email to the Forum Secretariat.  Refunds will be made within one month 
after the Forum.
5. The information provided in this form will only be used for the purposes of processing your registration, communicating with you on matters related to the Forum. Participants and organization name will be shown on the Forum Handbook. You can decide not to disclose your information in the forum handbook, or you can have access and correction with respect to your personal data held by us. If you wish to exercise these rights, please contact the Forum Secretariat.
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|         ________________________________________________ |         _________________________________________________ | 
|        
  Signature         
   |     Date | 
| I hereby agree to be bound by the rules and regulations of the Forum | |