Registration Form

To register via Fax or Mail, get our PDF form.

Early registration deadline is November 1^st, 2011.

To register on-line, please complete the following form:

Conference registration fee is $1,095 (Early registration fee is $995 with payment received by November 1, 2011). Payment may be made by check made out to the Washington International Education Council or with a MasterCard, Visa or American Express. If payment will be by credit card please be sure to provide the billing address for the credit card and the name on the credit card.

Each institution is entitled to two representatives for the single registration fee. Representatives in addition to the first two pay a nominal fee of $250.00 each. You may register up to five individuals on the form below. Registration fee includes participation in all seminars and Embassy visits, transportation to the Embassy visits, luncheons on both days and the Conference reception.

Please click on submit when you have completed filling out the form.

An invoice for your registration fee will be sent to you.

Yes, we will attend the 10^th Washington International Education Conference.
Monday, January 23^rd and Tuesday January 24^th, 2012

Institution:

Fill the information for each Representatives

1^st Representative

Last Name:
First Name:

Title:

Email:

Phone:

2^nd Representative

Last Name:
First Name:

Title:

Email:

3^rd Representative

Last Name:
First Name:

Title:

Email:

4^th Representative

Last Name:
First Name:

Title:

Email:

5^th Representative

Last Name:
First Name:

Title:

Email:

Provide the Billing Address for Credit Card Payments Below

Address:

City:

State:
Zip Code:

Fax:

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