Registration Form s19

WCEE 2008 Beijing October 12-17, 2008 Beijing, China Registration Form

Please complete this form and return it to: Staff use only Ms. Yu SHEN, CICCST/14WCEE Registration No.: 86 Xueyuan Nanlu, Beijing 100081, China _____ Fax: +86-10- 62174126

Please type or write clearly in block letter.

PERSONAL INFORMATION

Family Name ______First Name ______Sex:  Male  Female

Institute/Affiliation ______

Mailing Address: ( Office  Home) Street Address ______

City, Zip Code, State/Province ______Country______Paper ID: ______

E-mail ______Tel. ______Fax

PASSPORT DATA FOR VISA INVITATION (Participant and Accompanying persons)

Name in Passport: Family Name First Name Nationality Occupation Passport No.

Participant: ______

Accompanying Person (1) ______

You would like your visa to be issued in ______(City) ______(Country)

Registration Fees

Category Before After Aug. 1 Person(s) Amount Aug. 1 /QTY Full Registration   US$550 X US$475 Full-time Students   US$320 X Registration US$280 Accompanying Persons   US$250 X US$200 One Day Registration Fee   US$160 X US$160 Extra Paper’s Fee   US$150 X US$150

Subtotal (1) US$ ______

Grand Total: US$ ______

METHODS OF PAYMENT:

 I have remitted the above grand total from my bank ______on (date) ______payable in US dollars (copy enclosed) to Bank of China, Head Office. Address: 1 Fuxingmen Nei Dajie, Beijing 100818, China. Swift code: BKCHCNBJ. Account No.: 00038008091001. The beneficiary is CICCST. I have written ““WCEE’08”” and my name in the place of “Message”.

 I will pay by Credit Card. Please mark:  Visa Card  Master Card  American Express Card

Please charge my credit card for the above grand total US$______

Credit Card No.

Expiry Date (yyyy/mm)

Name of Card Holder

Card Holder ‘s Signature ______

Signature ______Date ______

Contact: Ms. Yu SHEN, CICCST/ WCEE’08, 86 Xueyuan Nanlu, Beijing 100081, China Fax: +86-10- 62174126 E-mail: [email protected]