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Serial No.
REGISTRATION FORM
REGISTRATION FEE:
BELTA members: Tk 400
Non-BELTA members: Tk 500
Discount Fee: Tk 200 for School Teachers & University Students of English Departments
Registration Sites:
English Dept, Presidency University, Dhaka: Mortaza 01670597234; Moshiur 01721347803
English Dept, South East University, Dhaka: Kamruzzaman 01680728897
English Dept, International Islamic University, Chittagong: Mohammad Riaz Mahmud 01715034598
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4. Contact Address:.
5. Phone Number: ..
e-mail :
..
6. Registration Fee: (Please choose appropriate Fee from above) : Taka
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Please report at 8:30 a.m. on Saturday October 22, 2016. The conference will start at 9
am sharp.
Show this counterfoil to claim conference bag, papers, meal token.
Name :
..
Institution:
..
Member
Non-member
Amount Paid : Tk
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OFFICE USE ONLY: Name and Signature of Person receiving Registration Fee:
Name: Signature Date: