PRINTABLE REGISTRATION FORM FOR 2009 D.C. SHAW CONFERENCE (No Credit
Cards)
It is much
preferred that you register online with a credit card at www.xxxxx.xxx, but if you can’t do that or do not
want to leave a credit card # online (though the site is secure), you can fill
out the following form and send it and a check or money order for the total
cost of registration (made out to the “International Shaw Society”) to “ISS,
P.O. Box 728., Odessa, FL 33556-0728.”
For questions, call the ISS president, Professor Richard Dietrich, at
(813) 503-0584 or email him at dietrich@cas.usf.edu
or mail him at the address above. Please note that for all but “Day Session”
registrants, included in the price of registration is an opening reception, 2
buffet dinners, tickets to 2 Shaw plays, & chartered busing at night. See www.shawsociety.org/DC-Shaw-Conference.htm
for other conference details. Back
to Conference Table of Contents.
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# |
TYPE OF
REGISTRATION FEE First, circle the row selected from rows 1
through 6. Then circle the row
selected from rows 7 or 8. Item 9 is
optional. |
FEE IN U.S. DOLLARS Add $25 per person if
after Sept. 1, 2009 |
#
Per
Item |
Total
Cost Per
Item |
|
1 |
Standard
Registration Fee |
$175
per person |
|
|
|
2 |
Registration
Fee for International Shaw Society Members [You
can join now to get this discount and others.
Go to www.shawsociety.org and click on "Membership
Application"] |
$125
per person |
|
|
|
3 |
Non-participant
Family Member or Guest Fee or CUA
Faculty & Staff Fee & Non-ISS Member |
$80
per person |
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|
|
4 |
Student
Registration Fee for non-ISS members (Student
ID Required) |
$100
per person |
|
|
|
5 |
Student
Registration Fee for ISS members (You can join now to get this
discount and others. Go to
www.shawsociety.org and click on "Membership Application") |
$50
per person |
|
|
|
6 |
One
Day Session (no meals or plays) |
$25
per person |
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A C C O M M O D A T I O N S: |
# of days |
Total per item |
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|
7 |
A
block of rooms has been reserved at the Hilton Rockville (Twinbrook Station
on the Metro Red Line). Reservations
(first come, first served) will NOT be made for
you. To make a reservation, reserve
online at http://www.hilton.com/en/hi/groups/personalized/IADMRHF-ISS-20091015/index.jhtml
or call (301) 468-1100. |
$109 + tax per room
per night. Request
rate for Shaw Conference. Parking extra.
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|
Pay
Hotel |
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8 |
I
will commute or arrange other accommodation.
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9 |
Campus
Parking Permit Needed? ($7 per day) |
Yes
or No? (Circle One) |
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YOUR
TOTAL COST FOR ALL ITEMS: $ |
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NAME &
ADDRESS: Name(s) ________________________________________ _______________________________________________ Title (Circle One):
Professor Dr. Ms.
Mr. Other: Address__________________________________________ City__________________________________________ State or Region____________________ Country: __________________ Postal Code__________ Telephones (with country code): __________________ Cell Phone # (with country
code):_____________________ FAX # (with country code):________________________ Email Address (essential):_________________________ Travel
Information: Arrival Date________Time_____
Departure Date______ Name & Address of place you're staying if not
the Hilton Rockville:____________________________________ |
Name-Badge Information: Please print your name & affiliation or
city/town as it should appear on your name-badge: ____________________________________________ ____________________________________________________ PAYMENT
INFORMATION: Please total your
registration and optional costs from above and enter that on the Amount Paid
line below. Then provide payment
information: Name of
Registrant______________________________________ Amount Paid $_____________ Method of Payment (Circle One): Check - Money Order - Cash (Must be in a
currency that can be converted to dollars in a U.S. bank) PLEASE
NOTE: 1.)
Registration is not complete until fee is paid in full. 2.)
Registration fees will be refunded (less a $35 handling charge) if written
notice of cancellation is received before September 1, 2009. No refunds can be made after that date. 3.)
If you require a visa for travel to the United States, please contact your
local U.S. Embassy or Consulate for detailed information on the requirements
for obtaining a visa. Information is
also available at usembassy.state.gov.
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