Are you currently a member of ACTE? Yes No
For Members Only: * Is this your first ACTE Global Conference? Yes No
Special Needs: If you require special attention or if there is anything we can do to make your attendance at the conference easier, please specify:
ACTE Member* 425 EURO
ITM Member* 425 EURO
Cardholder Name Card Number Exp Date
Priority Code/Comments * If paying by check, mail completed form with check to: ACTE Registration Office, 111 South Pine Street, Burlington, WI 53105 United States