ACTE Executive Forum

Registration Form


Beijing 5 November 2004 All fields are required unless marked with a "*". Name, Title and Company will appear on badge as submitted.
Name
Title
Company/Affiliation
Address
Address*
City
State/Province*
Zip/Postal Code
Country
Telephone
Facsimile*
E-Mail
Registration Fee:
	ACTE Member $29 USD Non-Member $59 USD Non-Member Joining $345 USD Complimentary $0 ( If registering as a comp, please include "code")

Payment:
	Check American Express Diners Club MasterCard Visa
Cardholder Name
Card Number
Expiration Date
(Please note - all cheques must be in US Dollars and made payable to ACTE. Mail your cheque to ACTE 333 North Bridge Road, #05-00, KH KEA Building, Singapore 188721) You may submit this form online by Fax: 65-6336 2583 or Mail: ACTE 333 North Bridge Road, #05-00, KH KEA Building, Singapore 188721, You may call 65-6336 4341 for questions or more information or email: [email protected].