Registration Form

 

  
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 $0 USD - Complimentary
Non-Member $39 USD
Non-Member Joining $330 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 37/F Singapore Land Tower, 50 Raffles Place, Singapore.)


You may submit this form online by Fax: (65) 6728 3863 or
Mail: ACTE 37/F Singapore Land Tower 50 Raffles Place Singapore.
You may call (65)6728 3863 for questions or more information or email: [email protected].

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