GENERAL INFORMATION (Please print): Given Name : ___________________________________   Family Name _____________________________________________ Title __________________________________________   Name for Badge : _________________________________________ University/Company _______________________________________________________________________________________ Business Address _________________________________________________________________________________________ _______________________________________________________________________________________________________            City                                State                                    Zip                                     Country Telephone : ____________________________________   Fax : ___________________________________________________ E-mail : (please print clearly) ________________________________________________________________________________ RECEPTION /BANQUET ATTENDANCE (included with registration fee) Please check the appropriate space. □ I will attend reception      □ I will not attend reception      □ Vegetarian □ I will attend banquets (Friday evening)      □ I will not attend banquet □ My spouse/guest will also attend reception/banquet (Add $90.00 reception / $120.00 dinner, to total fee) Fee includes conference registration, welcome reception(s), banquet and Proceedings. REGISTRATION FEE - Please complete the appropriate space(s) and indicate the total fee paid. Fee is to be paid in U.S. dollars. Refunds are subject to a $50 cancellation fee. KSMS Active/Current Member Conference Registration $510.00 New KSMS Member Conference Registration (Includes discounted current year membership dues for one year) $560.00 New KSMS Student Discount (Includes current year membership dues for one year) (Expected Graduation Date __________) $460.00 Spouse/Guest Lunch (Thursday) $ 35.00 Spouse/Guest Banquet (Friday) $ 50.00 EARLY BIRD DISCOUNT (by April 30, 2012) - $50.00 Total Amount Due ________ PAYMENT DETAILS : Please provide the following information. Only VISA and MASTERCARD are acceptable Card Number : __________________________________________________    Exp Date : ______________________________ Name of Card Holder : ____________________________________________    Signature : _____________________________ Send completed form to the following place by either e-mail or fax: 2012 Global Marketing Conference at Seoul Central Office Korean Scholars of Marketing Science 9 Sarimdong, Changwon, Republic of Korea www.kamsconference.org Tel : +82 55 213 3346 Fax : +82 55 263 9096 E-mail : stride@changwon.ac.kr Global Marketing Conference, Central Office, Dept. of Business Administration, Changwon National University Sarim-dong, Uichang-gu, Changwon, Gyeongsangnam-do, Republic of Korea Tel : +82-55-213-3346, Fax : +82-55-263-9096     Copyright ⓒ 2011 KSMS. All Right Reserved.