IACL Membership Application

IACL 19 will be held on June 11 through 13, 2011, at Nankai University, in Tianjin, China.

Conference web site: http://nkyyx.nankai.edu.cn/nkyyx/index.html.

On-line application form

Fields marked by '*' are required.

1. Name in Roman letters: Last name / 姓: * , First name: *

2. Name in Chinese characters 中文姓名:

3. Mailing address in Roman letters:

* (street)

* (city / state / zip code)

* (address4)

4. Mailing address in Chinese, if applicable 中文住址:

5. Telephone @ work (including area code):

6. Telephone @ home (including area code):

7. Fax:

8. E-mail:*

9. Web site: http://

10. Institutional Affiliation:

11. Department Affiliation:

12. Interests and specializations:

13. Select one of the following account types: * regular member ($30) student member ($15) life member ($300)

14. To access your account in the future, you need to create your own user name and password:

user name:* password:*

15. Security code:* (Enter the pinyin for without tones)