Event Registration Form
 
Institute  
Dates  

Fee including registration, institute materials, and continental breakfasts and lunches.

 

Multiple-person discount:  Fee applies when teams of three or more from the same institution attend the same event.

  
 

If you have any questions, please feel free to contact:

Dr. Marie Racine at 202-274-5633
 or mracine@udc.edu
Building 38  Room A19
University of the District of Columbia
4200 Connecticut Avenue NW
Washington, D.C. 20008

* denotes a required field

For multiple person or group registration, enter a contact person or group representative in the fields at left and the remaining names, one name per line, below:
* Name:
* Dept/Discipline:
* Institution:
* Work Phone:
Home Phone:
Fax:
* E-mail:
   
Select Event:    
 
   
* Method of Payment:
Please bill me. Use the following Purchase Order number:
A check made payable to "University of the District of Columbia" is being sent to:

Dr. Marie Racine
Building 38  Room A19
University of the District of Columbia
4200 Connecticut Avenue NW
Washington, D.C. 20008

I am registering as a participant from the host school. My registration is being paid by my institution.
 
* Payment Amount:
Discount Code (if applicable):

Questions/Comments/Reasons for Attending:

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