Sixth KSAALT Annual Conference
Diversifying Education: Teaching, Learning & LanguageMay 2nd
, 2013Prince Mohammad bin Fahd UniversityAl Khobar, Saudi
Arabia
CONFERENCE REGISTRATION FORMPlease print and return in person.1.
Participations Information
Name Badge and Mailing Information
Title: MRS
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, conference program and registration materials.
CategoryMemberNon-MemberEarly Bird (from 13 Jan until 28
Feb)
SAR225SAR275Regular (from 1 Mar until 31 Mar)
SAR250SAR300Late (from 1 Apr until 2 May)
SAR350SAR370Student Rate not applicableSAR100Presenter
SAR125SAR150
3. Payment
Payment Information
Conference fee:
SAR
I will pay the amount:
( by cash( Direct Deposit (Acct No: ) (352-228712-150 SABB
BANK)*
(IBAN: ) (Hossam Aboelazayem Elsayed)
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 refunded if notice of cancellation is received by April 1st,
2013. After April 1st, 2013, no refunds will be made. No shows are
non-refundable.
Confirmation: Please allow up to 15 days for confirmation of
your registration.* Should you decide to pay your registration fees
via the KSAALT Bank Account, kindly send a scanned copy of the
transfer receipt to us by email to [email protected]. Thank
you.
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:
______Careemah___________________________________
Name in print: _________Careemah Choong Lay Kheng___
Date:
_____31________ / ______1_______ / ________13____
Contact Information:
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