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Workshop on Clinical Training Program of Acupuncture SkillsTaoyuan, Taiwan

Venue:

長庚紀念醫院桃園分院

Taoyuan Branch, Chang Gung MemorialHospital(

桃園縣龜山

333

頂湖路

123

號

No.123, Dinghu Rd., Guishan Shiang, Taoyuan County 333, Taiwan(R.O.C.))http://www.cgmh.org.tw/eng2002/index.aspDate: April 25

- May 3

, 2009Language: English & Chinese are the official languages of the workshop

報名表

Registration

Reservation Form

Please type in block letters the present Registration & Reservation Form andreturn it to the:8F, No.123, Dinghu Rd., Guishan Shiang, Taoyuan County 333, Taiwan,R.O.C.email:roberta@adm.cgmh.org.tw,robertapan25@gmail.com

與會人員

(DELEGATES)

姓

(Surname)

名

(Given Name)

職稱／稱謂

(Title) (Prof./Dr./Mr./Mrs./Miss)

性別

(Sex)

國籍

(Nationality)

服務單位

(Institution)

地址

(Mailing Address)

郵遞區號

(Zip code)

區鎮市

(City)

縣市

(Country/Area)

電子信箱

(E-mail)

電話

(Phone)

傳真

(Fax)

隨行人員

(ACCOMPANYING PERSON)

姓

(Surname)

名

(Given Name)

注意事項：若隨行人員亦需參加

workshop

則請另行填寫申請表

Announcement: If accompanying person is to join the workshop as well, please fill out a Registration Form

Page 4

註冊申請

(REGISTRATION)

註冊費

Registration fees

Delegates: Free!

(Sponsored by Committee on Chinese Medicineand Pharmacy, Department of Health, Taiwan)

Registration includes:

•

Admission to the workshop

•

Certificate of attendance

•

Workshop teaching Materials

•

Workshop Manual

代訓證書語言版本

Language of Certificate of attendance



中文

(Chinese)



英文

(English)

注意事項：代訓證書語言版本限擇一申請

Announcement: Certificate of attendance only provides one language

訓練手冊語言版本

Language of Workshop Manual



中文

(Chinese)



英文

(English)



西班牙文

(Spain)

注意事項：訓練手冊語言版本限擇一申請

Announcement: Workshop Manual only provides one language

住宿預訂

(HOTEL RESERVATION)



(A) No, thanks

與會人員自行安排住宿

I will arrange my accommodation.



(B) Yes,

住宿

HotelName

長庚養生文化村

Chang Gung Health and Culture Village(http://www.cgmh.org.tw/cgv/index.htm)

單人房

Single Room(2 beds)AboutNTD$1,530/night/person



雙人房

Double Room(2 beds)AboutNTD$765/night/person



同住人員姓名

Staying with my accompanying person:



主辦單位安排同住人員

Staying with roommate arrangedby workshop organizer

班機抵台日

Arrival Date

2009/

班機編號

Number of flight

時間

Time

班機離台日

Departure Date

2009/ /

班機編號

Number of flight

時間

Time

住宿天數

Number of nights

nights

Taiwan Taoyuan International Airport

(C.K.S International Airport) is the closestinternational port of entry to Chang-Gung (Linkou medical center & Taoyuan branch). It is locatedapproximately 30 minutes south of Chang-Gung (Linkou medical center & Taoyuan branch).

Taxi Information

(A typical taxi fare from Taiwan Taoyuan Airport to Chang-Gung Linkoumedical center or Taoyuan branch is approx. NT$ 800.)http://www.taoyuanairport.gov.tw/english/index.jsp

Hotel Information

(It is located approximately 10 minutes east of Chang-Gung Linkou medicalcenter & Taoyuan branch. Workshop organizer only provided accommodation service; delegates shouldpay to hotel directly)

大會僅提供住宿預訂服務，住宿等相關費用請直接與長庚養生文化村結清。

Address:

桃園縣龜山鄉舊路村

鄰長青路

號

（

No.2, Changcing Rd., Gueishan Township, Taoyuan County 333, Taiwan (R.O.C.)

）

Page 5