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Eight KSAALT Annual Conference Innovation in EFL in the Saudi Context May 2 nd , 2015 Al Khobar, Saudi Arabia CONFERENCE REGISTRATION FORM 1. Participation’s Information Name Badge and Mailing Information Title: First Name: Surname: (this name will appear on your name badge) Institution / Organization: Department / Unit: Mailing Address: City / Country: Postal Code: Work Phone: Cell Phone: E-mail: Fax: 2. Conference Fees Conference fees include admission to conference sessions, one lunch, and conference program and registration materials. Category Member Non-Member Student Package (membership + conference) Early Bird (from 13 Jan SAR300 SAR400 SR150 SR475

Conf Registration Form May 2, 2015

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Page 1: Conf Registration Form May 2, 2015

Eight KSAALT Annual ConferenceInnovation in EFL in the Saudi

ContextMay 2nd , 2015

Al Khobar, Saudi Arabia

CONFERENCE REGISTRATION FORM

1. Participation’s InformationName Badge and Mailing Information

Title: First Name: Surname:

(this name will appear on your name badge)Institution / Organization:

Department / Unit:

Mailing Address:

City / Country: Postal Code:

Work Phone: Cell Phone:

E-mail: Fax:

2. Conference FeesConference fees include admission to conference sessions, one lunch, and conference program and registration materials.

Category Member Non-Member

Student Package(membership +

conference)Early Bird (from 13 Jan until 28 Feb)

SAR300 SAR400 SR150 SR475

Regular (from 1 Mar until 31 Mar)

SAR350 SAR500 SR175 SR 525

Late (from 1 Apr until 2 May)

SAR400 SAR600 SR 200 SR 575

Presenter SR 200

Page 2: Conf Registration Form May 2, 2015

3. Payment

Payment Information

Conference fee: SARI will pay the amount by cash to : a. Muhammad Siraj —PMU male: [email protected]

b. Malikah Sisay –PMU female: [email protected]

c Georgios Kormpas ([email protected])--Riyadh

d. Philline Deraney -Al Khobar/Dammam:

[email protected]

e. Sana Salam—UD Rakkah female: [email protected]

f. Amani Al Ghamdi—UD main campus Dammam female:

[email protected]

g. Hamdallah Alhusban—UD male: [email protected]

h. Mark Murray—Jubail Men: [email protected]

i. Thomas Wood—Hofuf—KFU: [email protected]

j. Jawaria Iqbal - ARAMCO :[email protected]

k. Careemah Choong – ESGA/COE [email protected]

l.Osama -KFUPM :[email protected]

m. Hossam Al Mana Hospital & Conference Treasurer:

[email protected]

n. Dennis Brittingham – JIC :integrity [email protected]

Alternately pay to your chapter treasurer

Al Khobar : Mrs.Careemah Choong ([email protected])

Riyadh : Ms. Bushra Albayaty ([email protected]

Yanbu : Mr. Mahmoud Al Meski ([email protected])

Abha :Dr. Areej Hussein – ([email protected])

Jeddah:

Page 3: Conf Registration Form May 2, 2015

4. Additional Instructions

Deadlines: Registration fees of different categories can be submitted in person no later than the deadlines stated as above at a KSAALT monthly meeting. Please consult the KSAALT website at www.ksaalt.org for the dates and locations of the monthly meetings. Please use ONE form per person (we apologize that Group Registration is not available this year).

Payment Information: Completed registration forms must be accompanied by full payment in order to be processed.

Refund Policy: Any cancellation of attendance should be notified to the Conference Committee in writing. Total conference fees will be partially refunded if notice of cancellation is received by April 1 st , 2015 . After April 1st, 2015, no refunds will be made. “No shows” are non-refundable.

Confirmation: Please allow up to 15 days for confirmation of your registration.

I hereby agree to pay the full amount of the conference registration. I have taken notice of the cancellation and refund terms stated on this registration form.

Signature: _________________________________________

Name in print: _________________________________________

Date: _____________ / _____________ / ____________

Contact Information:

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