Preregistration
| Name: |
___________________________________________________ |
| Affiliation: |
___________________________________________________ |
| Mailing
Address:
|
___________________________________________________ |
| ___________________________________________________ | |
| ___________________________________________________ |
Preregistration (Members only)**
| Regular: |
$60.00 | __ |
| Student/Unemployed
Members: |
$25.00 | __ |
| TOTAL
ENCLOSED: |
________ |
________ Check here if you will require sign interpreting. You must preregister for the meeting by 1 November 2001.
________ Check if you wish to receive information on child care options during the Annual Meeting.
Age(s) of child(ren) as of January 2002 _____
Send form and check made payable to LSA by 3 December 2001 to:
LSA Secretariat - Annual Meeting
1325 18th St, NW, Suite 211
Washington, DC 20036-6501
**On-Site Registration Fees:
Regular $70.00
Students/Umeployed Members $30.00
Note: Credit card payments will not be accepted for on-site registration under any circumstances.