Full Name
Identification
No.
Position
Address
City
Department
Name of institution
Home Phone
Office phone
Fax
E-mail
Levels you teach (Please, tick the option/s)
Pre-school
 Adult
Primary
 Private classes
Secondary
 Other
University
Copy your Davivienda deposit slip number (top corner) here:
Please, check if you want to receive information from
Universidad El Bosque.
To become a member and register to our Annual Conference,
follow instructions 1 to 3:

1. Make a deposit in DAVIVIENDA  savings account No. 0099 0021 0858 to
the name of ASOCOPI. (Check registration fee on the right)

2. Complete and submit this form
Conference & Membership Package
Includes Individual Membership & Conference Registration Fee
REGISTRATION FEE
(Individual)

First Deadline:
June 30, $200.000

Second Deadline:
August 31, $250.000

Final Deadline:
Sept. 30, $300.000
Take advantage of
early registration
fees.

These are the only
fees available and
there are no
discount for groups.

Please bear in mind
that there will not be
on-site registration.

The last date for
registration to the
Conference is
September 30, 2013
CANCELLATIONS
Cancellations of
Conference
Registrations
received before
September 15, 2013,
will incur a 50%
cancellation charge.
Cancellations after
this date will not be
refunded.
3. Send a scan of the deposit slip to the e-mail asocopi@yahoo.com

*NOTICE: Membership forms without copy of the payment receipt sent to
our office will not be processed.

You should receive confirmation of your registration within 7 days after
sending the copy of the deposit slip.

If there is no DAVIVIENDA office in your city or town, please call
+1  211 50 18 for further instructions.