registration_form_eng by liuhongmei


									                                                                                  GCCCE/ICCAI 2001 Registration Form   1

                                         GCCCE/ICCAI 2001
                            5th Global Chinese Conference on Computers in Education/
                         International Conference on Computer-Assisted Instruction 2001
                                                June 8-10, 2001
                                      National Central University, Chung-Li

                                           Registration Form

I. Information for Participants
1.   Please type/write the registration form clearly in order to keep your rights and interests.
2.   EACH participant should fill in ONE registration form. Please make registration separately, do not fill in
     one form with more than one participant.
3.   The Conference Registration includes: Proceedings, CD-ROM, Lunch for three conference days, Refection,
     Welcome Party on June 8th. (Banquet on June 9th is not included).
4.   All payment must be made in Taiwan Dollars(TWD): (1 US dollar≒33 TWD), subject to change.
5.   The Conference host only accepts the money orders payable in Taiwan. (Scholars from Mainland China
     please buy money orders in banks from Hong Kong or from other foreign countries. Please ensure the
     Money Orders are payable in Taiwan‟s bank.) All Money Orders are rated in Taiwan Dollars (TWD).
     Therefore, the sum stated on a bill must write in TWD. The Remittee title is: Chen Hsiao Wei.
6.   If cancellation and refund should be necessary, all cancellation requests must be in writing and received by
     May 20th, 2001. Cancellation requests may mail to GCCCE/ICCAI 2001 Secretariat.               No refunds will be
     issued for cancellations received after May 20 , 2001. A service fee (30% of your total amount) will be
     charged for all cancellations.
7.   You could also download the Registration Form on line at, and MAIL or
     FAX to GCCCE/ICCAI 2001 Secretariat. A preference rate would be given to early registration before May
     10th, 2001.

II. Personal Information
Title: □ Prof. □ Dr. □ Mr. □ Ms. (Please check)
Last Name (English): ____________________________________________________________________
First Name (English): ____________________________________________________________________
Chinese Name: _________________________________________________________________(optional)
Affiliation: _____________________________________________________________________________
Address: _______________________________________________________________________________
Postal Code: ____________________________________________________________________________
Phone (Country code/Area code/Tel #): ______________________________________________________
Fax (Country code/Area code/Fax #): ________________________________________________________
E-mail: ________________________________________________________________________________
Paper Author: □Yes: Paper Code(s): ____________________________________________( Please list all)
                                                                                 GCCCE/ICCAI 2001 Registration Form   2

III. Registration Fee
A. Registration Fee (Please check)

Option                                       Early Bird                                Regular & On-site
                                             (Before May 10th, 2001)
□ Regular                                    TWD. 3,500                               TWD. 4,000
□ GCSCE Member
□ GCCCE 2000 Participant                     TWD. 2,500                               TWD. 3,000
□ K-12 Teachers (Not include
College/ Univ. Prof.)
□ Student                                    TWD. 1,500                               TWD. 2,000
1. GCSCE membership code: ______________________________(optional)
2. Special Meal Order:
    □Vegetarian     □ Muslim          □ Special diet: _____________( please specify)
3. Students Information:If applied as Student Registrant, please be sure to complete all the following
    requested information.
    Tutor‟s Name: ___________________________
    Tutor‟s signature: _________________________( exempt for e-mail registrant)            Date: ______________
4. Proceedings Preference: (No extra charge for registrant)
    □CD-ROM Only □ Proceedings Only □ Both CD-ROM & Proceedings
5. Please note that the Registration Fee does not include the Banquet on June 9th.

                                                            A. Sub-total Registration Fee: TWD______________

B. Extra Order Fee (Please Check)

Option                                           Price                     Quantity    Total
□ 3 days lunch (at Conference Hall)              TWD. 300 (per person)                 TWD________
□ Ticket for Welcome Part on June 8              TWD. 500 (per person)                 TWD________
□ Ticket for Banquet on June 9                   TWD. 1,000 (per person)               TWD________
□ Proceedings                                    TWD. 1,000                            TWD________
□ CD-ROM                                         TWD. 200                              TWD________
□ Postage for Proceedings or CD-ROM              TWD. 500 (each)                       TWD________
* Post of Proceedings or CD-ROM for Extra Order only.

                                                          B. Sub-total Extra Order Fee: TWD______________
                                                                                 GCCCE/ICCAI 2001 Registration Form   3

C. Hotel Reservation Fee
Reservations are made by completing this form and returning it by fax to Ms. Chen Hsiao Wei, Fax
#886-3-4261931 by the deadline date of May 20th. Hotel rooms are subject to limited offer, the priority would be
granted for two-person booking for one room first. Bookings are confirmed at “first come, first serve” basis. The
hotel room registration would be delivered over to Hotel Reservation Department, please ensure you complete
all the following requested information.

Title: □Prof. □Dr. □Mr. □Ms. (Please check)
Last Name (English): ________________________________________________________________________
First Name (English): ________________________________________________________________________
Chinese Name: ______________________________________________________________________(optional)
Affiliation: _________________________________________________________________________________
Address: ___________________________________________________________________________________
Postal Code: ________________________________________________________________________________
Phone (Country code/Area code/Tel #): __________________________________________________________
Fax (Country code/Area code/Fax #): ____________________________________________________________
E-mail: ____________________________________________________________________________________
Name of accompanying person: ________________________________________________________(optional)
Arrival Date: ______________________________                Depart Date: _______________________________
Arrival Time: ______________________________                Special Request: _______________ (Please specify)
Required nights for accommodations: ____/ ______/_____ - ____/______/_____           (total ________ nights)

 Check               Hotel                                Room Type                              Special Price
     □     NCU Guest House           Budget Room (two small beds).                          TWD. 800
     □     Chinatrust Hotel          Superior Single (one large bed may for two people)     TWD. 2,900
     □     Chinatrust Hotel          Executive Single (one large bed may for two people) TWD. 3,600
     □     Chinatrust Hotel          Superior Twin (two small beds)                         TWD. 3,300
     □     Chinatrust Hotel          Deluxe Twin (two small beds)                           TWD. 3,500
     □     Garden Hotel              Single (one large bed may for two people)              TWD. 1,700
     □     Garden Hotel              Twin (one large bed, one small bed)                    TWD. 1,900
     □     Garden Hotel              Deluxe Suite (one large bed may for two people)        TWD. 2,800
1.   Rates of Chinatrust Hotel and Garden Hotel both include breakfast (Single room for One Breakfast, Twin
     Room for two). NCU Guest House does not offer breakfast.
2.   If you want to stay in NCU Guest House, please make reservation before May 15 th. If you want to stay in
     Chinatrust Hotel or Garden Hotel, please make reservation before May 20 th. Above special rate are subject
     to limited offer.   Bookings are confirmed at “first come, first serve” basis. Please pardon us if no hotel
     rooms are available because of a late reservation.

                                                    C. Sub-total Hotel Registration Fee: TWD______________
                                                                                  GCCCE/ICCAI 2001 Registration Form   4

D. Social Program Fee (Please check)

                        June 8th                           June 9th                             June 10th
                                         □ Tour 1                                      □ Tour 1
                                         □ Tour 2          □ Tour 3                    □ Tour 2
               □ Tour 1                  □ Tour 1          □ Tour 4
               □ Tour 2                  □ Tour 2
Tour 1: Half-day tour to Shi-Men Reservoir (TWD. 750)
Tour 2: Half-day tour to Pu-Xin Sightseeing Pasture (TWD. 970)
Tour 3: One-day tour to Dong-Shan River Scenic Resort (TWD. 900)
Tour 4: One-day tour to Ocean World, Yeh-Liu (TWD. 1,200)
All tours include entrance ticket, transportation, handling charge, and insurance (one-day tour includes lunch).
A Tour will be made with more than 20 participants. See full descriptions in tour program note.

                                                  D. Sub-total Special Program Fee: TWD______________

                                         Total Amount (A+B+C+D)=TWD____________________

IV. Payment Information (A complete registration is made after full payment)
□    Money Order (M.O.)
    I will remit total amount: TWD____________________
    Date of Money Order: _____/_____/_____
    Issuing bank: __________________________
    Money Order Number: ___________________________________________________

    Money Order Information
    Account Name: Chen Hsiao-Wei
    Account Number:242-50-162398
    Acct. with Bank: First Commercial Bank

    1.   Title Name of M.O.: Chen Hsiao-Wei, and please also mail to GCCCE/ICCAI 2001 Secretariat (No
         alteration or abbreviation. Please attach a copy of Registration Form)
    2.   The bank service charge will be disbursed by the remitter.
    3.   If you are unable to acquire the M.O., please hand in the total amount (in Taiwan Dollars) to Secretariat
         on the Conference day. And please ensure to tick the „cash payment‟ option.

□    Cash Payment
    Please hand in your cash payment (Taiwan Dollars) to GCCCE/ICCAI 2001 Secretariat.
    Total Amount: TWD___________________

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