2004 SEATJ Registration Form

Name…………………………………………………………………………

Affiliation……………………………………………………………………

Address………………………………………………………………………

E-mail………………………………………………………………………..

Phone………………………………………………………………………..

Fax…………………………………………………………………………..

I am enclosing a check of $…………………………………………………

Check payable to: Clemson University Foundation

Language Program Development # 5500463

I will have my own transportation at the conference: Yes_____ No_______

I need travel support: Yes_____ No_______

If yes, please indicate the reason.

Complete the registration form and send it with a check by February 27 to:

Toshiko Kishimoto

705 Strode Tower,

Clemson, SC 29634-0535