Registration
| REGISTRATION OPTIONS: A. Secure ON-LINE Registration: B. Email, FAX or mail form to Center C. Download Printable FORM MAIL OR FAX REGISTRATION FORM TO 860) 439-5311 NAME ________________________________________ AFFILIATION ___________________________________ ADDRESS _____________________________________ PHONE _______________________________________ EMAIL ________________________________________ Full registration includes all events and concerts. Dinner additional. Presenter Registration $250.00 ________ Advance general registration (until February 1, 2008) 275.00________ Regular general registration (after February 1, 2008) 300.00________ Graduate Student registration 75.00________ Dinner, Friday evening 40.00________ Chicken or pasta (please circle) TOTAL US$_______________ |
| CHECKS: Make checks payable and mail to: Ammerman Center for Arts & Technology Connecticut College, Box 5365 270 Mohegan Avenue New London, CT 06320-4196 USA |
CHARGE: (MC/VISA) Name on card ___________________________________ Amount charged: US$_______________________________ Credit card #: ______________________________________ 3 digit security code: _____________ exp. date____________ |
