!!! Please send only page 1 for individual and page1,2 for group membership!!! icon

!!! Please send only page 1 for individual and page1,2 for group membership!!!




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!!! Please send only page 1 for individual and page1,2 for group membership!!!

TESOL - Ukraine membership 2013

Teachers of English to Speakers of Other Languages in Ukraine

http://tesol-ukraine.at.ua


Send your application and the copy of the receipt (the details are on the fourth page) on fee payment (bank requisites are new for year 2013!!!) by e-mail to: tesol-ukraine-2012@list.ru In the subject of the e-mail, please, indicate your surname and oblast.

(Please print legibly)







First and Last Name in English




Title (If Candidate of Sciences or Doctor of Sciences)




telephone number (s)




e-mail




Повна чітка адреса українською мовою (прізвище, ім’я, по-батькові включно), на яку надсилатимуться друковані матеріали

^ You must be a resident of Ukraine




Institution name /Department/Position/

Contact Address




Active Professional Membership(s):




Previous travel and study or research experience in the U.S., UK or other foreign country (dates, purpose, program)






Date : _________________________ Signature : __________________________________________


Joint membership

^ MEMBERSHIP LIST 2013

City/village and oblast____________________________Coordinator_______________________


(Please print legibly)



First and Last Name in English

та прізвище, ім’я, по-батькові українською мовою





Contact Information

(telephone number, e-mail)

1.












2.












3.












4.












5.












6.












7.












8.












9.












10.













Your membership is valid for a calendar year 2013.


Coordinator_______________________

Date ____________________

^ Send your application and the copy of the receipt to: tesol-ukraine-2012@list.ru

Important!!! In the subject of the e-mail, please, indicate your surname and oblast!


In five business days you will receive the confirmation of including your data into TESOL-Ukraine database (Your private information will be used for sending you educational materials and for TESOL-Ukraine purposes only!)

NOTE:

The individual TESOL-Ukraine membership fee (four Forum magazines, participation at TESOL-Ukraine events for reduced payment for every member): 100 UAH

The joint TESOL-Ukraine membership (not more than 10 people) fee (four Forum magazines per group, participation at TESOL-Ukraine events for reduced payment for every member): 500 UAH

The Student TESOL-Ukraine membership (not more than 10 people) fee (four Forum magazines per group, participation at TESOL-Ukraine events for reduced payment for every member): 350 UAH

Your membership is valid for a year of 2013 since the date of your payment and must be paid not later than March1, 2013 to be subscribed for the ^ English Teaching Forum!

Внески Асоціац ії викладачів англійської мови «ТІСОЛ-Україна» сплачуються у відділеннях Приватбанку.

За послуги додатково потрібно сплатити 0,75% від суми платежу.

http://www.privatbank.com.ua/title.html (You can find in their menu line “филиалы» and then your city with all the addresses)

Please, do take a copy of the bank requisites with you when you go to pay.

The payment is taken in Privat Bank offices

The bank requisites:

Реквізити поповнення карткового рахунку

НОМЕР КАРТИ 4627 0817 1494 1650

В призначенні платежу вказати: благодійний внесок

Банк: ПриватБанк

р/р 29244825509100 МФО 305299 ЗКПО 14360570


Please save your fee payment receipt!


Send your application package by e-mail to: tesol-ukraine-2012@list.ru

Important!!! In the subject of the e-mail, please, indicate your surname and oblast!




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