Travel Training
Sample of a Registration Form

79TH ANNUAL CONFERENCE - REGISTRATION FORM
April 15-19 Atlanta, Georgia
Please type or print clearly
Full Name:__________________________________ ___________________________________
(Include nickname for badge, if desired)
Title: ______________________________________ Institution: ___________________________________
Mailing Address: ___________________________________________________________________________
Telephone ______________________ Fax _____________________ E-Mail ___________________________
ACCOMODATIONS FOR ATTENDEES WITH SPECIAL NEEDS: For any special arrangement, such as enhanced audio amplification, specific dietary requirements, physically challenged, oral, or sign interpreters, please contact us.
CONFERENCE FEES: The conference registration fee includes all open sessions, conference sponsored materials, refreshment breaks, the Exhibit Hall reception, the Awards reception, and the Annual Banquet.
  1. Member: Early Registration Fee (Postmarked by February 28)
  2. Member: Registration Fee (Postmarked after February 28)
  3. Non-member Registration Fee
 ________@ $280.00
________@ $380.00
________@ $480.00
PRECONFERENCE WORKSHOPS: Fee includes all sessions, working materials, continental breakfast, luncheon, refreshment breaks, and a reception.
  1. Deans and Directors Workshop
  2. Telecommunications Workshop
 ________@ $75.00
________@ $125.00
TOTAL __________
$ METHOD OF PAYMENT:
______ Check enclosed ______ Institutional Purchase Order Attached # ____________________
Credit Card: ______ Visa ______ MasterCard Card # ___________________________________
Expiration Date _________ Credit Card Signature ________________________________________
RETURN COMPLETED FORM AND FEE TO: Annual Conference
Circle, Suite 615
Washington, DC 20036
AMOUNT PAID: __________________
RECEIVED BY: ___________________
DATE: __________________________

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