Preferred Workshop Date 1 *

MM

DD

YYYY

Preferred Workshop Date 2 *

MM

DD

YYYY

Preferred Workshop Date 3 *

MM

DD

YYYY

Preferred Workshop Date 4 *

MM

DD

YYYY

Equipment *

Mobile speakers (with 2 microphones)

Mobile projection screen

Mobile projector

Table x 2

Chair x 6

Others *pls specify in REMARKS