Registration Form

After registering for any course on this registration form, you will receive an e-mail confirmation along with the registration form for participants to fill out to complete the registration. You can register simply by calling SILAKA Receptionist at 023 272 872/210 902 or 012 79 23 79 and/or coming by SILAKA office at #55B-55C, Street 390, Sangkat BKK3, Khan Chamkarmon.

Full Name *

Sex

Position

Mobile *

E-mail *

Organization/Company Name

Company Address

Company Phone

Company Email

Course Name

Start Date

Number of Participants

Place

Command

 

Staff Email
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