Last Name
First Name
Academic Affiliation
Mailing Address:
Street
City
State
Zip
Phone
Cell
Fax
Contact Info After Aug 15 (OPTIONAL):
Street
City
State
Zip
Phone
Cell
Fax
Email Address
Email Address must be entered correctly twice
Email Address
Fees: $65 (after 08/15/04) employed member $50 (after 08/15/04) underemployed member $50 (after 08/15/04) student
Graduate students may request partial reimbursement
Meal Plan: $135 All meals (Thurs dinner -- Sun brunch) $60 Friday meals only $60 Saturday meals only $0 I will not participate in any meals $0 Graduate student attending in an official capacity
Should you wish to communicate with the conference organizers you may use the field below: