MSA
Fall
Conference 2004
Registration Form
Your name:__________________________________________
Institution:
__________________________________________
Preferred Mailing
Address:
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
Phone number(s):____________________________________
E-mail:
_____________________________________________
Fees:
| Student....................................................................................$24.00 |
| Professional (Faculty,
Researcher etc.)..................................$48.00 |
| Contribution to
MSA
_______ |
| TOTAL
ENCLOSED
_______ (Check or Money Order Only) |
Make check or money order payable to:
Michigan Sociological Association.
Please print this
form
- one for each person - and mail with your payment to:
Alan Hill, Department of Sociology
Delta College
University Center, MI 48710
Return to 2004 Conference Page