Personal Information

Prefix:
First Name:
Last Name:
Address:
City:
Province/State:
Postal Code/ZIP:
Country:
Email:
Phone:
Affiliation:

Conference Registration

(includes coffee breaks, lunch on Friday and dinner on Saturday)

Regular $95 Student $40

Banquet

Saturday evening location and time tba

I plan to attend the banquet dinner on Saturday evening Yes No Unsure

I will be bringing guest(s) @ $40/each (includes tax/tip but not alcohol)

Payment Method

My total payment for the conference registration is and I will pay by
Cash @ workshop Cheque @ workshop Mailed Cheque

All cheques are to be made payable to University of Alberta and can be in either Canadian or US funds. All cash payments must be made in Canadian funds.

Please mail cheque to: Melanie Marvin History and Classics 2-28 Tory Building Edmonton AB T6G 2H4
All registration inquiries can be made to Melanie Marvin