11th BRAZ-TESOL NATIONAL CONVENTION - Pre-Convention Institutes Registration Form

Pre-Convention Institutes Registration

REGISTRATION FORM - PRE-CONVENTION INSTITUTES (PCIs)
Name:
Address:
City:		State:
CEP:
TEL (home):		TEL (work):
FAX:
Institution:
Position:		E-mail:

BRAZ-TESOL membership
	Yes, I am a member of BRAZ-TESOL. My membership number is and expires in (month).
	I used to be a member. Here is my renewal fee and a completed membership application form.
	I'm not a member. Here is my membership fee and completed membership application form. (R$50,00)
	I'm not sure. Please check for me.
Reminder: to participate in the Pre-Convention Institute, you must be a member-in-good-standing.

Check the PCI you are registering for:

Critical Literacy in Teacher Education - Critical Literacy SIG (Full-day)

Connect, Communicate and Collaborate! - Edutech SIG (Full-day)

Developing Intercultural Competence in the Classroom - Culture SIG (Half day)

Tune In, Speak Out: Approximating Pronunciation Teaching to Students' Needs - Pronunciation SIG (Half-day)

Check the PCI you are registering for:

Full-day PCI: 10 a.m. to 1 p.m. and 2 p.m. to 5 p.m. (6 hours)
If you register before July 6:	R$ 40,00
From July 7 to July 11:	R$ 50.00

Sorry,Fees are not refundable
(There is no on-site registration for PCIs)

PAYMENT INSTRUCTIONS (Depósito em Conta)

Deposit your fees in the BRAZ-TESOL account:

BRAZ-TESOL
Banco Bradesco
Agência 1074 - Tutóia
Conta Corrente 47261-1
CNPJ: 79.991.063/0001-07

PAYMENT INSTRUCTIONS
PRINT YOUR NAME (AS IT APPEARS ON THIS FORM) ON THE DEPOSIT SLIP AND MAIL IT TO: braztesol@braztesol.org.br.