Name:
__________________________________________________________________________________
|
Institution:
______________________________________________________________________________
|
Address:
________________________________________________________________________________
|
City/State/Zip:
___________________________________________________________________________
|
| Phone: ____________________ |
Fax: ______________________ |
Email: ____________________ |
|
|
|
Special Services
If you require special accommodations/dietary
needs, please indicate here:
|
|
Conference Fees
Conference registration includes one ticket to the Welcome
Reception held at the Lexington Children's Museum, one ticket for the "Old Kentucky
Night" at the Kentucky Horse Park, the entire program, exhibits, Vendor Update Lunch
and Chapter Business Meeting Breakfast. |
|
Member |
Non-Member |
Amount |
___ Advanced Registration
(Postmarked by September 1 enters you into a drawing for a Dinner for Two $50 Gift
Certificate) |
$150.00 |
$200.00 |
$ _______ |
| ___ Registration (after September 1) |
200.00 |
250.00 |
$ _______ |
| ___ Student Registration (excludes social
events) |
50.00 |
50.00 |
$ _______ |
One Day Registration (excludes social events)
___ Sunday only, October 11
___ Monday only, October 12
|
75.00
75.00 |
75.00
75.00 |
$ _______
$ _______ |
|
|
| Continuing Education
Courses |
Saturday, October 10, 1998
|
|
|
| ___CE 1 PubMed: Train the Trainer (half-day course) |
75.00 |
$ _______ |
| ___CE 2 Digital Dilemmas: Acquisition, Use, and Copyright
Issues for Libraries (half-day course) |
75.00 |
$ _______ |
| ___ CE 3 Teaching the Adult Learner in the Library Setting
(full-day course) |
130.00 |
$ _______ |
Sunday, October 11, 1998
|
|
|
| ___ CE 4 Health Care Resources on the Internet (half-day
course) |
75.00 |
$ _______ |
Tuesday, October 13, 1998
|
|
|
| ___ CE 5 Providing and Evaluating Electronic Full-Text
Information Delivery (full-day course) |
130.00 |
$ _______ |
| ___ CE 6 Frequently Asked Technical Questions:
Telecommunications and the Internet (half-day course) |
75.00 |
$ _______ |
| ___ CE 7 Granted! NLM Grants Demystified (half-day course) |
75.00 |
$ _______ |
|
Additional Tickets for
Special Events
|
Welcome Recption at Lexington Children's Museum
(Note: One ticket already included in full Conference Registration) |
___ tickets @ $10.00 each |
$ _______ |
"Old Kentucky Night" at the Kentucky
Horse Park
(Note: One ticket already included in full Conference Registration) |
___ tickets @ $35.00 each |
$ _______ |
| Kentucky Guild of Artists & Craftsmen Fall
Fair, Berea |
___ tickets @ $20.00 each |
$ _______ |
Shaker Village of Pleasant Hill Tour
|
___ tickets @ $40.00 each
|
$ _______ |
William T. Young Library Tour
(indicate # wishing to participate) |
___ # attending tour |
Free |
| Hospital Librarians' Luncheon |
___ tickets @ $25.00 each |
$ _______ |
| State Association Leadership Development
Roundtable Breakfast |
___ tickets @ $10.00 each |
$ _______ |
|
Circle preference of Roundtable topic below: |
|
|
|
President/Strategic Planning/Leadership
Vice President/Meeting Planning
Secretary
Treasurer
Communications: Newsletters/Listservs/Web
Membership
Continuing Education
Outreach
|
|
|
|
Grand total |
$ _______ |
|
Mail Registration Form
and Check to:
|
|
Rick A. Brewer
Medical Center Library
800 Rose Street
University of Kentucky
Lexington, KY 40536-0298 |
|
| Checks/money orders for all fees are payable to
Midwest Chapter Medical Library Association. Cancellations must be
received in writing no later than September 15, 1998 for a refund. No
cancellations will be accepted after that date or during the conference. Refunds will be
processed after the conference.
|
| In-house use: |
| Processed by: |
Deposit date: |
Check no: |
Check amount: |
