| Name  |   | Nation/Region  |   | 
  
    | Organization  |   | Position  |   | 
  
    | Passport No.:  |   | Gender  |   | 
  
    | Telephone:  |   | Fax:  |   | 
  
    | Mobile Phone:  |   | E-mail:  |   | 
  
    | Accompanying Persons  | Name  | Position  | Name  | Position  | Name  | Title  | 
  
    |   |   |   |   |   |   | 
  
    |   |   |   |   |   |   | 
  
    | Conference Schedule[Please check all events you    wish to attend]
 | □ Opening Ceremony and the    General Conference  | □ Cocktail Reception  | □ China (Chengdu) International Education    Cooperation and Innovation Achievement Exhibition  | 
  
    | □ Ecological Education and    Sustainable Development(session    one)
 | □ Private Education  | □ International Early    Childhood Education  | 
  
    | □ Ecological Education and    Sustainable Development(session two)  | □ Art Education and Cultural Development  | □ Media Education  | 
  
    | □ Farewell Luncheon    & Closing Ceremony  | □ Field Trip to Chengdu    Educational Institutions | □ Chengdu City Sightseeing | 
  
    | Others  | □ Speech Application  | □ Sub-Conference  | □ Sponsorship  | 
  
    | Special Needs | □ Non-smoking Floor | □ Muslim Cuisine | □ Other Requirements | 
  
    | Registration Fee | Before August 31st | USD800  | After August 31st | USD900  | 
  
    | The registration    fee is $800 per person, including expenses for printed materials,    representative badges, meals and accommodation during the conference, airport    pickup, sight-seeing and other local costs involved during the conference.    Extra transportation costs and accommodations will not be compensated by the    conference organizers.     | 
  
    | Bank Account | Beneficiary/Receiver:Education Forum for Asia    Training Center,    Haidian, BeijingBank Name: Bank    of Beijing,    Shuang Yu Shu Branch
 Account Number:01090321000120111114830
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    | Payment Mode  |   | Total Number of APs: |   | Total Cost:   |   | 
  
    | Education Forum for Asia    SecretariatAddress: Room 1211, D Building of Guohai    Plaza, 17 Fuxing Road,    Haidian, Beijing,    PRC. 100036
 Tel: + 86-10-5970 6190,5970    6618    Fax: +86-10-5970 6618  E-mail: phoebe@asia-edu.org
 www.asia-edu.org
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    | Additional Comment / Requirements:      |