REGISTRATION – ACLA 2001, “TOPOS/CHRONOS” – APRIL 20-22, 2001

Please type or print clearly.

Mailing Information

Prof./Dr./Ms./Mr./

Last Name First Name M.I.

Institutional Affiliation (incl. Department/Field)

Address: Phone:

Fax:

E-Mail:

Final Title for Presentation:

Participant Information

Presenting Paper? Yes No

Chairing Panel? Yes No

A/V Requirements

VCR and Monitor

Overhead Projector

Slide Projector

Other (please specify):

Payment

Prior to 1 March 2001

Faculty member of the ACLA	$75
Graduate student member of the ACLA	$25

After 1 March 2001

Faculty member of the ACLA	$90
Graduate student member of the ACLA	$35

Non-members, all dates:

$100

_____ Yes, I wish to attend the optional Saturday banquet

$45

(Further information will be sent upon receipt of this form to those who elect to attend the banquet.)

Total Enclosed:

Checks or money orders (US currency only, please) should be made payable to “University of Colorado” and returned with this form by regular mail to the following address:

ACLA 2001
University of Colorado at Boulder
238 UCB
Boulder, CO 80309-0238