Mountain West Chapter
conference fees & registration form
september
30-october 2, 2004
Denver, Colorado
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Art Libraries Society of North America Mountain West Chapter conference fees & registration form
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In order to qualify for the pre-registration fee, registration form must be postmarked by August 30, 2004!
| To register for the conference, please print this page, fill out information, and mail it with check or money order payable to ARLIS/Mountain West to: | Tom Riedel Distance Learning Librarian Regis University 3333 Regis Blvd. D-20 Denver, CO 80221-1099 |
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Pre-Registration deadline 08/30/04 |
On-Site Registration after 9/1/04 |
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| ARLIS/MW Member | $60.00 | $75.00 | $_______ |
| ARLIS/NA Member (outside of MW region) | $60.00 | $75.00 | $_______ |
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Non-Member (Includes one-year membership to ARLIS/MW) |
$75.00 | $90.00 | $_______ |
| Chapter Membership 2005 | $15.00 | $_______ | |
| Staying at the Oxford Hotel | yes __ no __ |
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| Interested in Thursday Reception | yes __ no __ | ||
| Interested in Saturday Museum Visit | yes __ no __ | ||
| Interested
in Saturday Dinner at Tom's house |
yes __ no __ | ||
| Winberta Yao Travel Award Donation | $_______ | ||
| TOTAL ENCLOSED | $_______ |
Do you require a receipt for your registration fee? Yes ____ No ____
Institution: ____________________________________________________________
Address:______________________________________________________________
City, State:________________________________ Zip Code:___________________
Telephone: ___________________________________________________________
E-mail: _______________________________________________________________