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 □         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 10065

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

You also can pay conference registration fee online: