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 Rutgers University : free for members and presenters if registered by April 10, 2011 and subject to seat availability.  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 10065

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

You also can pay conference registration fee online:
Please note: If using a credit card with a name other than the paying member, be sure to indicate the member's name in the field of " Review Payment of Merchants ", before clicking "Pay" button on the Review Payment Page .