CCSC Presenter Registration Form
Eastern 2007 Conference on Oct. 12 - 13, 2007

 

Early Registration (9/15/07)

Late/On-Site Registration:

Cost per person

Total Paid

Cost per person

Total Paid

Registration

$130

 

$150

 

Extra Proceedings

$10

 

$10

 

Extra Friday Buffet Ticket

$50

 

$50

 

Extra Saturday Lunch Ticket

$15

 

$15

 

Total (sum of amounts paid):

 

 

Registration includes the following:  admission to all sessions, proceedings, banquet, and luncheon, one copy of the proceedings, copies of the CCSC Journal for the 2007-2008 academic year, and CCSC voting privileges for the same year.

 

Member ID: _______________________________

Change of address:  yes / no
Type of address:     home / institution

Name: ____________________________________________

Phone: _____________________

Position: __________________________________________ 

Fax:     _____________________

Department: _______________________________________

Email:  ___________________________________________

Institution: _________________________________________

I would like to receive mailings from the following regions: (circle at most eight): 

CP

E

MW

NE

NW

RM

SC

SE

Voting Region (please circle one)
 

CP

E

MW

NE

NW

RM

SC

SE

Address: __________________________________________

__________________________________________________

__________________________________________________ 

City, State Zip : ____________________________________

        Please circle if you do not wish your name included in a published participant list.
 

        Please circle if you do not want to be added the CCSC listserver(s).
 

Please write checks or money orders payable to the CCSC.  CCSC does not accept credit cards.

The Consortium will assess a charge of $25 for each check returned.

Please mail this form to the following:

 

S. Jane Fritz

St. Joseph's College

Business and Technology Center
Department of Mathematics and Computer Science
32 Audubon Avenue
Patchogue, NY 11772
Phone: 631.447.3289
Fax: 631.758.5997
E-Mail: Jane Fritz at sjcny.edu

For more information, please see:

http://www.sjcny.edu/CCSCE2007/

and/or http://www.ccsc.org/

Requirements for presenters are listed here. Please make sure that you review this page before submitting
your registration.

Regions are: Central Plains, Eastern, Midwest, Northeast, Northwest, Rocky Mountain, South Central, Southeast.