Office Use: #_____________

 

CONFERENCE REGISTRATION FORM

CHINESE TEACHERS ASSOCIATION OF GREATER NEW YORK

Family Name

English

 

 

Given

Name

English

 

中文

 

 

中文

 

Affiliation:

 

 

 

 

 

 

 

 

 

Work address

 

 

 

 

 

 

Email 1

 

 

Home address

 

Email 2

 

Fax

 

Telephone

Work

 

 

Home

 

Registration Fee:   $20 □      

Round-trip charter bus to College of Staten Island : free for members and presenters if registered by March 31, 2008.  After that date , $10 □

Board the bus in  □  Flushing  □  Manhattan

Make check payable to CLTA-GNY.

     Membership Status

Yes □  No  □ 

 

 

 

 

 

 

 

 

 

 

 

 

Please send the form back to:                          Chinese Language Teachers Association of Greater New York
 125 East 65th Street, New York, NY 10021

Or email the form to:                                        clta.gny@gmail.com

You also can pay conference registration fee online: 　
Payment for bus to College of Staten Island: