Preregistration
Name:
Affiliation:
Mailing Address:
Preregistration (Members only)**
| Regular | $60.00 | ______ |
| Student/Unemployed Members | $25.00 | ______ |
| TOTAL ENCLOSED | $_____ |
___ Check if you wish to receive information on child care options during the Annual Meeting.
Age(s) of child(ren) as of January 2001 _____
Send form and check made payable to LSA by 4 December 2000 to:
LSA Secretariat - Annual Meeting
1325 18th St, NW, Suite 211
Washington, DC 20036-6501
**On-Site Registration Fees:
| Regular | $70.00 | ______ |
| Student/Unemployed Members | $30.00 | ______ |
| TOTAL ENCLOSED | $_____ |
Note: Credit card payments will not be accepted for on-site registration under any circumstances.