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English Dept - Computers & Writing Conference Registration

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Registrant Information
Title*
First Name*
Last Name*
Street Address*
City*
State or Province*
Country*
Zip Code*
Other
(Special addressing concerns)
Phone*
Email*
School Name*
Position*
Other*
Special Dietary Needs
Shirt Size*
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Other Size
Registration Option
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Workshops
Free Workshop
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Pre-Conference
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Morning Workshops
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($50 per workshop, $80 if you sign up for one in the morning and one in the afternoon)
Afternoon Workshops
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($50 per workshop, $80 if you sign up for one in the morning and one in the afternoon)
Complete this section to reserve a room in Residence Hall
Nights Staying
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Room Request
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(If you have selected 'Double - Split with another attendee', please enter the name of the other registrant, who will complete a separate registration form, in the space provided below)
2nd Attendee's Name*
Special Needs
(ADA Accommodations)
Registrant Information for Second Occupant
Title*
First Name*
Last Name*
Street Address*
City*
State or Province*
Country*
Zip Code*
Other
(Special addressing concerns)
Phone*
Email*
School Name*
Position*
Other*
Special Dietary Needs
Shirt Size
  •  
  •  
  •  
  •  
  •  
  •  
Other Size
Second Occupant Registration Option
  •  
  •  
  •  
Second Occupant Workshops
Free Workshop
  •  
Pre-Conference
  •  
  •  
Morning Workshops
  •  
  •  
($50 per workshop, $80 if you sign up for one in the morning and one in the afternoon)
Afternoon Workshops
  •  
  •  
  •  
($50 per workshop, $80 if you sign up for one in the morning and one in the afternoon)