New Year’s Day Travel Registration Form

1. Date: Monday, January 1st , 2018

Time: 08:30am - Angkor Shopping Arcade, Svay Dangkum

09:00am - Puol Market, Puol District

2. Registration Deadline: Monday, December 25th, 2017

3. Fees: 2 USD/ person(Including Transportation and Ticket)

4. Location: សួនេស្នហ៍ជនបទ（េខត្តបន្ទាយមានជ័យ Banteay Meanchey）

5. Attendee’s Name:

6. Phone number:

7. Parent / Guardian ’s Signature:

*Please bring your own food with you*

Payment : □ Paid ______ USD □ Not paid

Handler / Payee’s signature: _______________

【Receipt - Parents keep】

Date of Payment: ______(Day) ______(Month) _______(Year)

Student’s Name: ___________________ □ Paid_______ USD

Handler/ Payee’s Signature: _______________

Handler/ Payee’s Phone Number: _______________________

*Please bring your own food with you*