SEAMEO Regional Centre for History and Tradition
Myanmar History from Myanmar Perspectives
REGISTRATION FORM

Please print and return this form to:   SEAMEO Regional Centre for History and Tradition
                                                        Pyay Road, Yangon, 11041, Myanmar
                                                        Fax; 95-1-515175
                                                        E-mail: seameo_chat@mptmail.net.mm
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I wish to register for the Myanmar History from Myanmar Perspectives programme to be conducted from 22th to 31th January 2008.

Please tick the appropriate
Title: Prof. : Prof Dr.  Mr. Ms. Mrs.others 
(Please specify)
First Name :
Middle Name :
Last Name :
Sex Male.   Female
Citizenship :
Date of Birth :
Place of Birth :
Passport No. :
Date & Place of issue :
Designation :
Academic qualification :
Institution/ Organization :
Contact Address :
City :
Post Code :
Country :
Telephone no. Office :
Residence :
Fax :
Email :
Additional message :
Name :
Signature :
 

( NOTE: Registration deadline is 30 November 2007.)