Registration Form for International Guest

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Registration Form for International Guest

Personal Information

First Name *

Last Name *

Title/Position *His Eminence. CardinalHis Excellency ArchbishopHis Excellency BishopMonsignorVenerableReverend FatherDeaconSr.Br.Mr.Mrs.Ms.Dr.Prof.

Please specific your title

Affiliation/Organization *

Representative Country *

Visa RequireNoYes

Do you need a support letter from the host?NoYesOnce you choose YES, the host will send the support letter to you via your email address.

Email Address *

Contact Number *

Accommodation (4 nights)

JD POLMAN Hotel & Residence, -Address: Building 1839, Street Guang Dong(P13), Phum Bayab, S/K Phnom Penh Thmey, Khan Sen Sok. Phnom Penh, Cambodia -Check-in: 2pm (26/05/2025) -Check-out: 12pm (30/05/2025)

Arrival Flight Number

Arrival Date *Logistic team will arrange pick-up service from airport on 26/05/2025.

Arrival Time

Departure Flight Number

Departure DateLogistic team will arrange send-off service to airport on 30/05/2025.

Departure Time

Special Accommodation Requests (if any)

Dietary Restrictions

Please Choose Dietary Restrictions (if any) *No allergies or dietary at allAllergies (please specific)Dietary Preferences/Restrictions (please specific)Religious or Spiritual Diets (please specific)Health-Related Restrictions (please specific)Other Restrictions (please specific)

Please specific

Additional Comments/Questions

Is there anything you would like to tell the organizers?

I understand that the information I submit will be held and shared with the organizers of this Colloquium. By registering, I agree to receive email communications about the Colloquium (e.g., concerning any changes to scheduled sessions).

Please do not fill in this field.