English in Action Six-month Registration Form International Form

English in Action Six-month Registration Form International Form

Use this form to register for 6 months.

If you want to register for 1 year, please use this form instead.

Indicates required field (*)

Please complete this form and all sections on the Paypal website in order to complete your English in Action registration.
Name: *	First name: * Last name: *
Street Address (Street Name and Number): *
City: *
Country: *
Postal Code: *
Phone (best number to contact you by): *
Email: *
EiA Registration If you are in more than one unit, please fill out this form for each unit you are in.
EiA Registration *	If attending, please select the number of EiA Registrations required: There is a 1 EiA Registration limit. 0 1 6 months of conversation sessions EiA Registrations @ $225 each
PLEASE MAKE SURE YOU HAVE RETURNED TO THE "REVIEW" PAGE AFTER ENTERING PAYMENT INFORMATION BEFORE CLOSING THIS WEBPAGE.