BMI Agents Workshop Asia 2019 – Bangkok, Thailand Application Form Bangkok, Thailand March 19th & 20th 2019 Each agency can have up to two participants free of charge. Accommodation is provided for agents from outside Bangkok. In this case both participants from the same agency will be sharing a twin room. For more information, please visit https://www.bmiagentsworkshop.com/thailand---march-2019.html Agency InformationAgency Name *Address *City *State/Province Country *Post Code Phone (with country code) *Website *Facebook Link 1st ParticipantTitle *Mr.Mrs.Miss.Prof.Dr.Name *Position Email *Mobile 2nd ParticipantTitle Not RequiredMr.Mrs.Miss.Dr.Prof.Name Position Email Mobile Description about your agency *This text will be printed in the Event Handbook and given to all participants. This should be a maximum of 250 words.First BMI Workshop? *YesNoName other workshops you participated in: Number of students sent abroad in the last year? *Agency Logo *Participant Picture *Second Participant Picture (if registered) Would you like to be informed about other BMI Workshops in Asia? Yes, please keep me updated about future BMI Forum & Workshops in Asia.No, thank you.1st ReferenceInstitution name *Contact person *Contact email *Contact telephone *Other References Other reference(s) you would like to give us in case we cannot contact the 1st reference:Hotel Accommodation BMI will provide 2 nights free accommodation (breakfast and lunch included on the days of the event) at the official workshop hotel and a networking cocktail dinner. Check in on 19 March 2019 Check out on 21 March 2019 Should you require an additional person in your room or an extra night before or after the free workshop nights, please email cristina@bmiglobaled.com for a quotation and credit card form. Institutions based in the same city as the workshop will NOT receive free accommodation.Accommodation required *Not RequiredSingleDoubleTwinCredit Card InformationCard Type *MasterVisaAmexCardholders Name *Card Number *Expiry Date *Security Code *Cardholders Billing Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryTerms and Conditions A credit card will be required by the hotel to allow check in for your free room as a BMI guest. Approved agencies will be given free participation in the two-day workshop. The credit card will be pre-authorised for USD 400 and will ONLY be charged in the event of: • No-show at the workshop • Not completing your schedule or missing your assigned appointments • Not attending the networking cocktail • Your cancellation for any reason in less than 30 days prior to the workshop start date Any miscellaneous charges incurred during your stay such as room service, laundry, extra nights, unauthorised additional person in your room, extra meals, drinks etc. will be at your own expense and automatically charged by the hotel to your card.I agree to the above Terms and Conditions *Yes ValidationPlease enter any two digits of your choosing so we know you are a real person. *Example: 12This box is for spam protection - please leave it blank:
