Registration Form for the 2011

Missouri Sociological Association Meeting

October 14-15, 2011

Please print this form and mail it with your dues and conference fee to:

Betty Cooper

2517 Portabello Place
Jefferson City, MO 65109

 

Name ______________________________________________________

Institutional Affiliation _______________________________________

Phone Number   ____________________________________________

Mailing Address  ____________________________________________

                                ____________________________________________

                                ____________________________________________

City, State, Zip  ________________________________________________________

E-mail address   _____________________________________________

Annual Dues, Registration Fees, and Luncheon: Please check the appropriate boxes:

Student Dues $5.00

Dues for All Others $10.00

Registration for Students $18.00 *

Registration for Students After 10/7/11 $ 20.00 *

Registration for All Others $30.00 *

Registration for All Others After 10/7/11 $ 32.00 *

Luncheon Saturday $15.00 (we need a complete count by 10/7/11)

* Conference Registration Includes breakfast Saturday morning.

Last updated: October 16, 2009