RED TEXT INDICATES A REQUIRED FIELD
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
Registration Fees: $70 Employed member $50 Underemployed member $50 Student
Graduate students may request partial reimbursement
Meal Plan: $150 All meals (Thurs dinner -- Sun brunch) $70 Friday meals only $70 Saturday meals only $0 I will not participate in any meals $0 Graduate student attending in an official capacity
Special Event:  Saturday Afternoon Visit to Smith-Berry Winery and Gallery! After Saturday lunch we will drive 25 minutes in vans and cars to the Smith-Berry Vineyard and Winery and return before dinner. The winery belongs to the family of artists and writers Dee and Clifford Amyx and Wendell Berry. See www.smithberrywinery.net   (The link opens a new window. Once you close it, this Registration form will be visible again.) I want to go on the Smith-Berry Winery Tour: Yes No
Child Care: (Optional) The Conference will provide child care during the Thursday evening session and the Friday evening author reading, by prior reservation. I want child care for: Thursday evening Friday evening Both evenings
Name of child:
Special needs:
Age of child:
For day-time child care needs, please list the the following: Name, age of child, session dates and times, special needs. WiG will try to arrange for this care, if possible. You will be charged at the caregiver's rate.
Special Needs, Comments, Questions: Please let the conference organizers know what you need to make the conference accessible to you. Be as specific as possible!