Registration Form

3rd PALT International Conference on Language Education
December 4-6, 2007, Manila, Philippines

Please accomplish and submit this to the Conference Secretariat. Registration closes when the number reaches 800.

Personal Information
Salutation: Prof Dr Mr Mrs Ms
Name:
Email:
Sex: Male Female
Nationality:
Official Position:
Institution:
Office Address:
Telephone No.:
 
Registration Fee (includes a kit, conference materials, morning and afternoon snacks, and lunches)
Up to November 15, 2007: Php 5,000.00 (USD 100) After November 15, 2007: Php 6,500.00 (USD 130)

Important: Deposit the amount rendered in cash, check, or wire transfer to any branch of Philippine National Bank (PNB) using the Savings Account No. 275-601840-2 with the account name Philippine Assoication for Language Teaching, Inc. (PALT). International wire transfers should bear the address PNB UP Diliman Campus, Diliman, Quezon City 1101 with swift code PNBMPHMM. Send a scanned copy, facsimile, or photocopy of the deposit slip bearing your name and the official registration form to the conference secretariat. Originals must be kept by depositors for verification during the distribution of conference materials from 5:00-7:00 p.m. on December 3 and from 7:00-8:30 a.m. on December 4.