The deadline to return this form is May 24, 2006 - you must print this form and please return this form along with your payment to the Center for Quality Assurance in International Education (CQAIE). To send payment by wire transfer, please contact CQAIE by e-mail, phone or fax for additional information.

Name (as you want it to appear on name tag):__________________________________________

Working Title: __________________________________________________________________

Organization: ___________________________________________________________________

Mailing Address: ________________________________________________________________

City: State: Postal Code: Country: ___________________________________________________

E-mail: Phone: Fax: ______________________________________________________________

Conference Registration

_____ Members of CQAIE from the United States and Canada	$500.00 US $__________
_____ Non-members from the United States and Canada	$600.00 US $__________
_____ Members and Non-members from Central and South America	$400.00 US $__________

Save by Joining Now:

Center Affiliation (Annual Membership Open to all interested - http://www.cqaie.org)

_____ Individual	$100.00 US $__________
_____ Organizational-Institutional	$1,000.00 US $__________
TOTAL AMOUNT ENCLOSED $___________

Cancellation Procedures
If you have paid your registration but are unable to attend, a replacement is welcomed. Notification of cancellation should be made in writing and received by CQAIE no later than May 10, 2006 in order to receive a 50% refund. Please note you will be responsible for cancellation of your own accommodation reservations.

Method of Payment (Registration will be processed at time of payment)

_____ check in the amount of US Dollars made out to CQAIE is enclosed

_____ Credit Card (Visa or MasterCard only): _____Visa or _____ MasterCard

Credit Card Number: _____________________________  Expiration Date: _____________

Signature: _______________________________________________________________

Print Name on Card: _______________________________________________________

Billing Address of Card Holder : ______________________________________________

_______________________________________________________________________

Please return this form along with your payment to the CQAIE. To send payment by wire transfer, please email, call or fax for additional information .