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The 2nd English Bilingual Education(EBE)/ 3rd EIS International Conference: on English for Integrated Studies for ASEAN Community Development January 24-27, 2013 At Chiangmai Phucome Hotel, Chiang Mai Province, Thailand Please refer to the information in the invitation mail. If you wish to participate in international conferences. Then you fill in the correct information. Complete and can be verified. Thank you very much.

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What is your name title? * (Please use capital letter in english language)

• MR.
• MRS.
• MS.
• Other:

What is your name? * (Please use capital letter in english language)

What is you surname? * (Please use capital letter in english language)

What is your job? *

• Supervisor
• School principal
• School vice principal
• Teacher
• Other:

What is your academic standing? *

• Expertise (คศ๕)
• Professional (คศ๔)
• Special expertise (คศ๓)
• Specialists (คศ๒)
• No

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What is your affiliation? *

• Primary education
• Secondary education
• Non-formal education
• Other:

Where you come from ? *

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