Puerto Rico TESOL 40th Annual Convention Friday and Saturday, November 1-2, 2013

MEETING 21 CENTURY NEEDS: ALIGNING CURRICULUM and Teacher Performance

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SHERATON PUERTO RICO HOTEL AND CASINO, SAN JUAN, PUERTO RICO PRE-REGISTRATION FORM
www.puertoricotesol.org - email: info@puertoricotesol.org
First Name(s): Expiration date: Chapter: Last Names: Membership ID #: Mailing Address: City: Phone (home): State/Country : Cellular: Email: Zip

Type of institution in which you work: Level: Elementary

Secondary

Public Private Workplace_______________________________________ Higher Education Administration

Convention Fees One day with lunch Friday, November 1, 2013 Preregistration
Before: Sept 19, 2013

Both days with lunch

Please check the appropriate option.

One day with lunch Saturday, November 2, 2013 Preregistr ation

Before: Sept 19, 2013

*Use a separate form for each registrant. Payment through a purchase order or institutional check, must include a separate registration form for each individual. Purchase orders must list each

Preregistration
Before: Sept 19, 2013

On Site
Lunc h not guar ante ed

On Site
Lunch not guaranteed

On Site
Lunch not guarant eed

Member NonMember *Student or Retired members *Student or retired NonMember

$140 $190 $110 $145

$190 $220 $140 $165

$90 $130 $90 $130

$120 $150 $110 $140

$90 $130 $90 $130

$120 $160 $110 $150

TOTAL AMOUNT INCLUDED:

$
Bank:_______________________________
PRTESOL will not honor requests for refunds. All checks returned to PRTESOL due to lack of funds are subject to a $15 penalty fee.

Money Order

Check Number: _____________________

Amount $_________ Received by:

FOR OFFICE USE Date Received _____________ _____________________