SI20 - Pre-Registration Form
Panama TESOL Summer Institute 2020
January 13 - 17, 2020
Universidad Latina de Panama, Vía Ricardo J. Alfaro: https://goo.gl/maps/gP4fdHSikJ8C96AT6


This pre-registration form is required for your enrollment in the event.

Note: This pre-registration form will become an official registration once your payment is validated.
PERSONAL INFO
Please use Initial Capital letter to fill every gap.
Title *
First Name *
Your answer
Middle Name
Your answer
Last Name *
Your answer
Professional Title *
Date of Birth *
MM
/
DD
/
YYYY
I.D. Number *
Your answer
City *
Your answer
Province/State *
Your answer
Country *
Your answer
Phone *
Your answer
E-Mail *
Your answer
PROFESSIONAL INFO
Institution/Organization *
Write the name of the institution/organization you work for.
Your answer
Functional Role *
Educational Level *
Employment Status *
Educational Sector *
Work Setting *
Required
Years of Experience *
The symbol "<" means "less than".
ORIENTATION RELATED
Areas of Interest *
Required
Areas of Expertise *
Select an area in which you have a high level of expertise. This data will be used to fulfill speaker requests, and to find experts to lead TESOL programs. If you don't wish to participate in these opportunities, please skip this field.
Required
1. Payments
Make all Payments at:
Banistmo / Panama TESOL / Checking Account / # 0101164441
If the link does not work, please send your slip to payments.panamatesol@gmail.com
Pre-Reg
On-Site
Pay On-site
Bank Payment/Deposit
Bank Transfer
Receipt/Transfer Number (#)
If you transferred/deposited, please add the transfer number/receipt number in the line below
Your answer
How Did You Find Out About this Event? *
Required
NOTIFICATIONS
Please show up at the registration booth to validate your registration at arrival.

If you have any inquiry, don't hesitate to contact us at the following lines:

Payment issues/ offers: payments.panamatesol@gmail.com

Form/ Registration issues: panamatesol@gmail.com

Institutional promos/ discounts: marketing.panamatesol@gmail.com

Phone: 65214785


THANKS FOR YOUR SUBMISSION

Panama TESOL ● TEACHERS OF ENGLISH TO SPEAKERS OF OTHER LANGUAGES ● An Affiliate to TESOL International ● Founded on September 20, 1986 ● Panama, Republic of Panama ● www.panamatesol.org
SEE YOU THERE!
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