2011 LACUSPA CONFERENCE ONLINE REGISTRATION

Complete the following registration form as instructed and submit all applicable fees by mail.
* Required Field
*
 First Name:
Last Name:
*
Institution:
*
Title:
*
Phone:
Fax:
*
Email:
*
 Address 1:
Address 2:
*
Type of
Institution:
*
Registration Fee**: (Check all that apply)
$35 EARLY BIRD RATE
Payment postmarked by September 8, 2009
$50 STANDARD CONFERENCE REGISTRATION
Payment postmarked by September 14, 2009
$10 EARLY BIRD RATE STUDENT CONFERENCE
REGISTRATION
Payment postmarked by September 8, 2009
$20 STUDENT CONFERENCE REGISTRATION
Payment postmarked by September 14, 2009
Questions, comments, or feedback:
** CONFERENCE REGISTRATION FEES MUST BE MAILED TO:
Dawn Miller
LACUSPA Treasurer
University of Louisiana at Lafayette
P O Box 42690
Lafayette, LA  70504
I have completed the above LACUSPA Conference Online Registration
to the best of my ability and agree to submit all applicable conference
registration fees, as outlined in this form.
Photos courtesy of the University of Louisiana System