MIMSAC @ The University of Memphis

MIMSAC 2008 Registration Form

Teaching and Learning in a Safe and Healthy Environment

Registration begins at 7:45 a.m. in the FedEx Institute of Technology Lobby.
Welcome and Keynote Session begins at 8:30 a.m.

Participant Name (to appear on name tag):

Title & Department:

Institution:

Address (with City, State, Zip):

Phone: (ex: 901-555-1111) Fax:

Email:
Note: A registration confirmation email will be sent to this email address.

Is this your first Memphis in May Student Affairs Conference? Yes No

Do you have a need for special accommodations due to a disability? Yes No
Please list your specific need:

Parking is available during the conference in the parking garage located on Deloach, near the Fogelman Executive Center. With advanced notification parking arrangements may be secured via registration. If we do not receive notification of your parking needs on this online registration form, parking will be at your own expense.

Do you require parking space? Yes No Number of Vehicles:

REGISTRATION & FEES

Early Registration ends on May 2, 2008.

	Early Registration Fees	Regular Registration Fees
Faculty/Staff	$70	$80
Students	$59	$64

Total Fees Enclosed (ex: $80): $

CANCELLATION/REFUND POLICY: No refunds will be provided. If you are unable to attend , you may send a substitute.

Mail copy of the online registration confirmation email and payment to:
The University of Memphis
P.O. Box 1000
Department 313
Memphis, TN 38148-0313

Payment accepted:
checks, money order, cash

Please make checks payable to:
The University of Memphis

For additional information, please call or email Julia Rhodes at:
(901) 678- 2188 or jrhodes@memphis.edu