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The Canon Unplugged: XII International Conference of the To register: Please complete and return the following registration form no later then May 31, 2001 with your check, or money order to: Dr. Inmaculada Pertusa FIRST Name: ___________________________________________________________ LAST Name: ___________________________________________________________ Institution: _____________________________________________________________ Address: _______________________________________________________________ ______________________________________________________________________ City: _______________________ State______________ Zip:________________ Country: _______________ Phone: _________________ Fax: _______________ E-mail:_____________________ Audio Visual Equipment request: _____ Slide projector and screen _____ TV/VCR _____ Overhead projector and screen ___ Please check here if you would be willing to serve as moderator of a session. Will you need to use parkimg facilities during the Conference? ___YES ___NO FEES: ____ Registration Fee: $ 60.00 ____ Business Luncheon on Friday, 14th, 2001: $12.00 TOTAL AMOUNT ENCLOSED $___________ Enclose check or money order payable to: University of
Kentucky (ALFH). |