AEPA2018 Registration Fee Payment Form
Please complete this form after the wire transfer has been completed.
Registered participant
First name : *
Your answer
Last name : *
Your answer
Email address : *
Your answer
Payment Details
Type of registration


Author - Registration : USD$650

Non-Author - Registration : USD$700

Student - Registration : USD$550

Educational Workshop : USD$50

Total wired : *
Your answer
Name of transferring Bank : *
Your answer
Address of transferring Bank : *
Your answer
Date of transfer *
MM
/
DD
/
YYYY
Transfer reference code : *
Your answer
Name of transferring person : *
Your answer
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