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Pre Registration Form  

The 7th Asia TEFL International Conference
“Collaboration and Creativity in English Language Teaching and Learning in Asia”
August 7-9, 2009
The Imperial Queens Park Hotel, Bangkok, Thailand


Please complete this form in English BLOCK CAPITALS.

Title

First Name

Family Name

Mr./Mrs./Ms.

 

 


Affiliation

...............................................................................................................

Mailing Address

........................................................................................................……


Telephone: Office (......)   (.......) .................... Home  (......)   (......).......................
                         (country code)  (area code)               (country code)  (area code)
Fax: Office (.......)   (.......) .............................  Home (......)   (......).......................
                (country code) (area code)                         (country code) (area code)  
E-Mail: ......................................................................................................................
o 1. I would like to join the conference as a presenter                              Baht 3,000 (US $ 100)
o 2. I would like to use the LCD in my presentation                                 Baht 1,000 (US$ 40)
o 3. I would like to join the conference as

      o member (Asia TEFL o or Thai TESOL member  o

Membership number _______________

Baht 3,000 (US $ 100)

      o non-member

Baht 3,300 (US $ 120)

      o student

Baht 2,700 (US $ 85)

o 4. I would like to join as an attendee and pay per one day                 Baht 1,300 (US$ 35)

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Total amount of payment (please complete)                                         Baht  ___________  (U$ __________ )

All payments are non-refundable.  Overseas participants must pay in U.S. funds only, handling fee included.

Methods of payment

o by bank draft/cashier’s check payable to “Thailand TESOL” (Personal checks will not be accepted.)   

 

o by bank transfer to “Thailand TESOL” Savings Account No. 045-2-53721-3 The Siam Commercial Bank Public Company Limited, Sapha Kachat Thai Branch.  

 

o by postal order/money order payable to Miss Srichan Tantineeranat, Chulalongkorn Post Office Phatumwan, Bangkok 10330, Thailand (For participants in Thailand only.)

 

o  by credit card

 

    o  VISA                               

o  MasterCard

 

 

 

Credit Card No.

                                             

                            

                        Expiry date                                        Signature of Cardholder                                           ____

 

Pre-registration is valid ONLY upon payment received by June 20, 2009

Late or on-site registration fee is Baht 4,100 (US $ 130) Cash Only

Pre-registration form together with payment must be sent to:
After sending registration form, please check your name at our website: www.thaitesol.org

Thailand TESOL c/o Ms.Srichan Tantineeranat c/o Chulalongkorn University Language Institute
Phaya Thai Road Phatumwan Bangkok 10330 THAILAND
Tel: 02-218-6100, 806-322-5360 Fax: (66) 02-218-6027
E-mail: srichan_t@hotmail.com
http://www.thaitesol.org

Copies of this form are acceptable