ONLINE REGISTRATION FORM

Basic information

First name: *

Last name: *

Email:

Academic affiliation (if any):

Name as you would like it to appear on nametag:

Street address:

State/Country:

ZIP code:

Registration information

Registration Fee (includes conference facilities, opening and Saturday receptions, continental breakfast Friday, luncheon Saturday). Registration must be paid by check, made out to Midwest ACIS.

Select your registration fee category Faculty/Non-student: $125 paid before Sept. 30, 2012
Faculty/Non-student: $125 paid after Sept. 30, 2012
Student: $80 paid before Sept. 30, 2012
Student: $85 paid after Sept. 30, 2012

ALL PAYMENTS MUST BE BY CHECK.
Please make out the check to Midwest ACIS and mail along with your registration to:
Timothy G. McMahon
Dept. of History
Marquette University
P.O. Box 1881
Milwaukee, WI 53201-1881
USA

Download PDF of registration form to submit with payment

Equipment needs

The main sessions of the conference will take place in the Beaumier Conference Suite in Marquette’s Raynor-Memorial Library. The suite is equipped to handle various types of A/V requests. Please describe below any A/V equipment needed.

A/V equipment needs:

2012 ACIS CONFERENCE REGISTRATION

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ONLINE REGISTRATION FORM

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