English Name:___________________________________ Taiwanese Name:_______________
Address:____________________________________________ City:____________________
State:________________ Zip code:____________________ Phone:_____________________
Registrants Information (please type or print clearly)
(For mailing purposes, please use a separate sheet for each registering family with correct address)
English Name (Last, First, MI) |
Taiwanese Name |
Gender (M/F) |
Age of Child |
Room Type | Staying Nights | Sub Total | |||
Single | Double | 7/3 | 7/4 | 7/5 | |||||
$ | |||||||||
$ | |||||||||
$ | |||||||||
$ | |||||||||
$ | |||||||||
$ | |||||||||
If mailed before June 6, deduct $15/person | -$ | ||||||||
T-shirt(s) ($10 each) | $ | ||||||||
Vendor Booth ($100/table) | $ | ||||||||
If walk-in, add $20/person | $ | ||||||||
Total | $ |
Conference Fee Schedule
Number of days | Adults (age 12 and up) | Kids (age 4 to 11) | |
Room Type | Double room | Single room | Double room |
3 days | $190 | $240 | $165 |
2 days | $160 | $215 | $135 |
1 day | $135 | $190 | $110 |
Please place your order for T-shirt(s) here:
T-shirt ($10 each) | Size | S | M | L | XL | Total Cost |
Quantity | $ |
Pre-Conference Survey (please check when applicable)
___ I/We [Name(s):__________________,____________________,_________________]
would like to stay in youth dormitary. (Must be 15 yeras of age or older)
Agreement Statement:
In case of a medical emergency, I hereby give permission for a health service physician to
hospitalize, secure proper treatment, and to order injections or minor syrgery for my child (children),
as named below:
Name:________________________________ Name:____________________________
Name:________________________________ Name:____________________________
Signature of parent or guardian:___________________________________
Payments
Please make check payable to : TAC/EC
and mail it with the registration form to:
TAC/EC
P.O.Box 2087
Acton, MA 01720
Information
If you have any question, please call
Peter Hwang (Registration) at 508-897-0724, or
Mei Tsai (Chairperson) at 508-473-7898
The 1997 TAC-EC Planning Committee
Boston Taiwanese American Association
e-mail TAC_EC@Taiwanese.com