Participant Payment Form
Use this form if you want to register as a non-presenting participant either for the full session (3 days) or one-day session (1 day only). Online payment can be made from now until 5 July 2018. On-site payment can be made any day during the conference.
Email address *
1. Name (as it will appear on certificate) *
2. Institution / School *
3. Phone number *
4. Nationality *
5. If you are Indonesian, which province do you live and work in?
6. How did you first hear about the 65th TEFLIN International Conference 2018? *
7. Paying as (tick where applicable) *
If you are a registered TEFLIN member, click here to upload an image of your ID card ( max 1 MB )
1. Please make your payment via electronic transfer to:
Bank: Bank Mandiri
Branch: KCP Sungguminasa, Gowa, Sulawesi Selatan
Account number: 174-00-0089204-2
Account holder: Amra Ariyani.TEFLIN
Swift Code: BMRIIDJA
Payer’s name (if different from item no. 1 above)
2. Scan or photograph your transfer receipt and upload the file here
A copy of your responses will be emailed to the address you provided.
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