Lao Emerald Friends

Register Form
(This form will be closed once the total amount of attendees (registered and paid) reaches 400. Final registration will be closed on June 10, 2019.)
Registration is required to attend the event. Please provide all required information below. (Keep in mind One person per registration)


First Name:		Last Name:
Address:		City:
Canada?	YESNO
State:		Zip code:
Email Address		Country:
Home Phone:		Cell:
Fax:		Number of Person

Comments:		Keep in mind One person per registration



Notice: The cost of this event for each individual is $100.00 (US dollar). Please send a personal check or $ order to
	Aromsay Chanthasoto
	23151 Kleinsmith Way
	Brambleton, VA 20148
	Cell: (703)314-6058
	email: aromsayc@yahoo.com
We will no longer accept payment and registration after 06/10/2019. Tickets will not be sold at the door, so plan accordingly.

If you encounter any problems during registration, please contact the followings via e-mail with complete registration information (Full name, Address, email, phone, country, attendees etc)
1. Mr. Ounesa Senesom at 727-422-8093 (osenesom@yahoo.com)
2. Mr. Bounlath Sourivong at 360-909-3404 (bounlathsourivong@yahoo.com)
3. Mr. Aromsay Chanthasoto at 703-314-6058 (aromsayc@yahoo.com)
4. Mr. Bounne Louangviset at 682-808-7166 (blouangviset@netzero.com)
Then we'll take care the rest. Please do not hesitate to ask, we're here to help.

Go to List of Attendees page click here