REGISTRATION FORM
Participant Details
Title* :   Position* :  
Family Name* :   Employer* :  
Given Name* :   Teaching Institution* :
Nationality* :
  Primary Phone* :
Country of Residence* :
  Secondary Phone :
Dietary requirement :   Primary Email* :
Participant type* :
  Secondary Email :
Payment type* :
     
Details to be Appeared on Your Name Tag and Certificate
Full Name* :  
Position (Optional) :
Employer/Teaching Institution* :  
Would you like to receive the Certificate of Attendance?  
 (Name on your certificate will be printed the same as your name tag. Certificate of Attendance for the Main Conference is only available for Saturday and Sunday registration only and will only be distributed after the closing plenary presentation.)
Conference Registration
Level of participation
1 day: (Saturday, 18 February) 
1 day: (Sunday, 19 February) 
2 days: (Saturday, 18 - Sunday, 19 February)
Level of participation
1 day: (Saturday, 18 February) 
1 day: (Sunday, 19 February) 
2 days: (Saturday, 18 - Sunday, 19 February)  
Pre-conference Activities
CamTESOL and UECA Regional ELT Research Symposium (Full day, Friday, 17 February)
CamTESOL and NEAS Regional ELT Leadership Forum (@ 2.00-5.30 pm, Friday, 17 February)
Educational and Cultural Visits (@ 8:30am-1:30pm, Friday morning, 17 February)
Tour #1: City Tour of Phnom Penh
Tour #2: Cultural Tour
Tour #3: Khmer Rouge Genocide Memorials
Tour #4: Mekong River Cruise
Tour #5: Private Language Schools
Tour #6: Public Schools
Tour #7: Regional Teacher Training Centre
Tour #8: Self Access Facilities (ELT focused)
Conference Dinner (Saturday Evening, 18 February)
Conference Dinner
* Main conference registration is required.
Sponsor rural Cambodian teachers
You, your school, college, university, organisation or company may wish to sponsor a Cambodian provincial teacher or a group of teachers to attend CamTESOL. All sponsors are acknowledged in the Conference Handbook. Sponsorship only covers the registration fee of US$80 per individual. Sponsors can decide on the number of Cambodian provincial teachers they wish to sponsor.
Number of teachers you wish to sponsor x US$ 80 = US$  
 
Total: US$
Terms and Conditions
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