PDK Taiwan - Welcome - Thanks for Registering with us
note: please have a digital picture of yourself ready - it is required below - any graphic format is ok - we need to use it for your ID pass - please use a picture that is mostly just of your face Electronic Membership is 1800NT/yr
Please fill in all fields marked with a *
	First Name	*
	Last Name	*
	Email	*
	School
	Position
	Grade Level or Subject
	Cell Phone
	Home Phone
	Work Phone with ext
	Country of Origin
	Picture of Yourself	*
any trouble with this form, contact dave wittry