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Student Science Training Program 2022

Institute of Molecular Biosciences, Mahidol University

Salaya, Nakhon Pathom

 
Privacy Policy
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The Institute of Molecular Biosciences collects your personal information to provide you the service. Your first and last name will be displayed on a specific page on the Institute website so that you can review the accuracy and status of your application.

For your own benefit, please make sure that the information given is accurate and complete.

Online Registration Form
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Vaccination record 
Please attached the Certificate of Vaccination
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Which period do you prefer to attend?
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First Name
Middle Name
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Last Name
Nickname/Name to be called
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Gender

Nationality

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Date of Birth
Open the date time chooser
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Address
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City/Province
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Postcode
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Home Phone
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Mobile Phone
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Email Address
ID Line
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Name of School
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Current Level
Special requirements:
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Is hot or spicy food edible?
(This question is mandatory)
Do you require special meal?
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Do you require food?
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Do you have any other dietary restrictions, e.g. allergies?
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Note
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How did you hear about the SSTP 2022?
(This question is mandatory)
Do you wish to receive news and updates from MB?
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Which channel do you prefer to receive information?
Parent/Guardian Information
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First Name: Parent/Guardian #1 
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Last Name
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Relationship
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Home Phone
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Work Phone
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Mobile Phone
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Email Address
Parent/Guardian #2
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Emergency Contact Person

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Emergency Contact Phone Number
Registration
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Registration Options: (Please choose one of the following)

●  Please note that the reservation fee of 5,000 Baht is non-refundable and is due at the time of registration, unless the full amount is paid.

●  Registration will not be accepted without a deposit or full payment.

●  Once your registration is accepted, you will be notified by email to proceed with payment of the remaining balance within the date specified.

●  Please email your photographic evidence of payment/bank transfer to kaewklao.ban@mahidol.edu Tel. 080-9814948.

 

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Parent/Guardian 
Photo and interview release and consent.
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Parent/Guardian Signature 

By typing your name in the “Parent/Guardian Signature” space, you acknowledge all points above and give your child permission to attend SSTP2022.

For further information, please contact Ms.Kaewklao Banjong,International Relations Officer at kaewklao.ban@mahidol.edu | Tel. 080-9814948