rev.tics031411 TICS Registration

Enrollment Registration for 32nd Session Texas International Cotton School August 6-17, 2012

Please fill in the form completely. Fields marked * are required. When complete, click on the "Submit This Form" button.

Personal Information
*First or Given Name:(firstname)
*Family Name or Surname:(lastname)
*Name you prefer to be called:(realname)
Date of Birth Month:

Day:

Year:

Gender:

City of Birth
Country of Birth:
*Citizenship(s)
Marital Status

Visa/Transit Information

*Are you a U.S. Citizen?

Passport Number:

*Do you have a valid U.S. Visa?

*If you have a valid U.S. Visa, what kind of Visa do you have?

Official Contact Information
(please remember this information will be offered to other TICS students & instructors)

*Permanent Shipping Address:(address1)
Permanent Shipping Address (line 2):
*City:(city)
*State or Province:(state)
*Zip or Postal Code:(postalcode)
*Country:(country)

*Telephone number (shipping contact), include International Telephone Codes:(phone)

Fax number
*Email address:(email)
Business Information

Name of Company or Institution :
Supervisor:
Supervisor's title:
Address:
Additional Address (line 2) :
Shipping Address (if different than above) :
City:

State/Province:
Zip/Postal Code
Country

Company Telephone number:
Email address

Fax number:
Background Information

How did you find the Texas International Cotton School?

Your education level:
Your current position:
Experience in the Cotton Industry:

Please understand that all classes and lectures are presented in English. A strong background in written and spoken English is advised. Please indicate your level of fluency in English:

 
Do you have any special dietary needs?

If "yes,", what are they?
Do you have any special medical concerns?

If "yes,", what are they?

BE ADVISED--Unless you plan to have your own mode of transportation, you will be required to stay at the school hotel.
Therefore, do you have any special requests regarding lodging?
Do you plan to bring a laptop computer to this Session of the TICS?

All registrations require a $100 Registration Fee (nonrefundable) to be valid for reservation of space and visa processing.  Register, then  click on Lubbock Cotton Exchange.