I 23 Ubocofficialform-new[1]

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XXIV Universiade 2007 Bangkok, Thailand Organising Committee Universiade Bangkok 328 Si Ayutthaya Road, Ratchatewi, Bangkok 10400, THAILAND Tel: 66 2610 5499 Fax: 66 2610 5485 – 87 Email: [email protected] Internet: www.bangkok2007.com

Individual Entry Form Country

I 23

UBOC Officials

Country Code Last Name

First Name

Roman Alphabet

Photo M

Sex

Nationality Date of Birth

F

Place of Birth dd

mm

yyyy

ID Number

Expire Date dd

mm

yyyy

Organization/University City

Zip Code

Country

Phone

Fax

Email

Supreme Board Member

Executive Office of the UBOC

Organizing Committee Member

The UBOC Staff

Committee Member

Volunteer

UBOC Honorary Member/Guest

Observer

Other Guest/Sponsor

I will be accompanied by

Other function not listed above Function

ORGANIZING COMMITTEE

Title

Contact Person Mr/Mrs. ………………………….…............... Tel. ……………...……… Email …......….……………………. Date /

/

Applicant’s Signature .

Date /

/

Name and Signature of the Committee Chairman/UBOC Executive Director .

For UBOC Category

V M AD

Village

Seats

R S T U Z

Press Center

O

Date /

/

I

AD

AD

Access Code

Opening & Closing Ceremonies

R S T U Z

AD

0 1 2 3 4 5 6 7 AD

UBOC Executive Director Approval .

Entry to be sent back no later than 30/05/2007. One (1) copy must be sent to the Kasetsart University. Please Keep a copy for your own records. No copies to the FISU Secretariat.

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