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.

NO REFUNDS

 

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

Please note: This form must reach us NO LATER than October 20, 2004.

 

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