Registration Form

Title*

	Mr
	Mrs
	Ms
	Dr
	Prof.

	First Name*

	Last Name*

Gender

	Female
	Male

	First Name (as will be printed on the name tag)*

	Street Address *

	City*

	State

	Zip Code

	Country*

	Mobile phone number *

	Email address*

Dietary constraints?

If you are also an Exhibitor, how many tables (approx.100cm x 200cm)would you like to be reserved for you?

	one table
	two tables

If you would like to bring posters about projects related to the Conference title, how much space would you like to be reserved for them?

	approx. 60cm x 60cm
	approx. 84cm x 60cm
	approx. 126cm x 60cm

	Name of organisation or employer

	Position

	Organisation's or employer's website

	Companion's first and last name (only if he/she joins in receptions and dinner)

	Email Address

Companion's dietary constraints?

	Which Conference strand would be your first choice?* *

	Which Conference strand would be your second choice?*

Conference Participant's Fee - the Registration will be accepted when payment of registration fee is received - please see "Registration Fee" on AIE Website) *

	Early Bird (until 31 March 2010)- 390 GBP
	Regular (from 1 April 2010 on) - 420 GBP
	Other:

Companion Fee (when joining in the receptions and dinner)

	Early Bird (until 31 March 2010)- 60 GBP
	Regular (from 1 April 2010 on) - 80 GBP
	Other:

	How did you first hear about the Alliance for International Education?

Media and Website Permission (I give permission for my picture to be featured in selected media and on the AIE website)*

	Yes
	No

	Questions or Comments

Please Note: Questions marked with an asterisk (*) are required.

Partnership Websites