Asia Pacific (PITH) 2025 Conference – Thai Registration Form

PERSONAL DETAILS

Registering For *

Individual
Couple
Family
Group

You need to fill in a separate form for each separate person participating in the conference (even infants).

Couple/Family/Group ID

Couple/Family/Group ID = Family/Last Name/Group Name

Title *

First/Given Name (as on passport) *

Last/Family (as on passport) *

Email *

Email

Confirm Email

Mobile Phone *

Will be used by IBCM Network staff for arrival and departure purposes only.

Residential Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country of Residence *

Date of Birth *//

Gender *

Male
Female

Is your husband/wife coming with you? *

Yes
No

Please note if you answer "YES" you still need to complete a separate registration form for your spouse. The details below just lets us know both names of each couple.

Spouse Title *

Spouse First/Given Name *

Spouse Last/Family Name *

Do you need translation from English into another language? *

Yes
No

Languages offered are: Thai, Indonesian, Korean

Language *

Language you need translation for

Are you willing to translate at the conference?

Yes
No

Languages offered are: Thai, Indonesian, Korean

Language I will translate into is *

Dietary Requirements

Further Dietary Information

PASSPORT DETAILS

Passport - Country of Issue *

Passport Number *

Passport - Date of Issue *

Passport - Expiry Date *

CHURCH & MINISTRY

Church attending *

Christian organisations you work with (if any)

Nature of personal ministry

TRAVEL DETAILS

Do you need a Visa in advance? *

Yes
No

You must apply for a visa yourself. To do this go to https://thaievisa.go.th/

Do you need a formal letter of invitation to the conference? *

Yes
No

Do you need transport from the airport to the conference centre? *

Yes
No

Transport will be provided from the airport to the conference centre on Friday July 25. Return transport will be provided to the airport on Monday July 28.

GO-SERVE MISSION TRIPS

Do you intend to participate in a short-term mission trip following the conference? *

Yes
No

Short term mission trips covering different ministries in surrounding countries including Thailand, Malaysia, and the Philippines will be offered following the conference to a limited number of participants. The mission trips will cost between US$300-$1000. If you select yes more details and a mission trip registration form will be sent to you.

CONFERENCE OPTIONS

Conference Elective Track Selection *

During the conference there will be a number of elective sessions related to the above areas.

CONFERENCE FEES (per person)

Amounts are in Thai baht.
Registration closes on June 30, 2025.
Early Bird closes on January 31, 2025.

Are you applying for a supported place? *

Yes
No

What level of support are you requesting? *

Half Conference Fee

Supported places and the amount of support able to be given to each will be limited by the funding that is available.

Fee Options - per person (select one) *

1 - THAI CONFERENCE ONLY - Conference, No Accommodation - includes 2 meals each day (lunch & dinner) - (6600)
2 - THAI CHILD - 3 -12 year (3300)
3. - THAI DAILY RATE

All rates are in Thai Baht

Days Attending (2600 baht/day) *

Friday July 25
Saturday July 26
Sunday July 27
Monday July 28

If sharing a room with whom would you like to share?

Total Conference Cost (baht) *

What amount would you like to pay now? )Baht) *

Deposit (1100) Baht
Full Amount

Amounts are in Thai Baht.
Pay by Bank Transfer to:
KASIKORN BANK, PHUKET BRANCH
Account no : 102-2-40017-5
SWIFT code: KASITHBK
Account name : Christian Assembly Paklok
Address: 14 Pang Nga Road, Talaadyai Sub District , Muang,Phuket,Thailand , 83000

Conference Payment (baht) *

Amounts are in Thai baht

Credit/Debit Card - Ignore if paying by transfer

Card

Name on Card

Conference Participant List - I am happy to share my name and email address with conference participants? *

Yes
No

Disclaimer
1. I declare that I am a member or associate of a Christian Brethren church or organisation.
2. I understand that by submitting this form I confirm that the information given on this booking form is accurate and that I recognize that it is necessary for IBCM Network to hold and process the personal data provided for the purposes of IBCM Network and the Asia Pacific (PITH) conference in accordance with our privacy policy (https://www.ibcm.net/about/), and to communicate with me about it.
3. I confirm that I will pay the balance of the conference fees owing by the due date.

Disclaimer *

I Agree