Registration Form

Workshoppers Around the World:
What Lessons Have We Learned?

Registration Form

(All Information Required)

First Name
Last Name
Title
Affiliation

Department
Institution/Organization
Street
Street (2)
City
State
Zip Code
Country
Telephone
E-Mail
Fax
Personal Webpage

Name and Affiliation will be included on your badge.

Additional Information

Childcare:
Childcare Services will not be provided for WOW4.

Dietary Restrictions:

Accessibility needs:

Deadlines

To qualify for the reduced pre-registration rate, participants must register by April 30, 2009.

Pre-registration for the Workshop on the Workshop 4 closes at 5:00 p.m. on April 30.

Conference Fees (June 3-6, 2009) Number Attending	Before 4/30	After 4/30
Faculty/Professional	$75.00 per person	$100.00 per person	Number Attending:
Graduate/Undergraduate Student	$25.00 per person	$40.00 per person	Number Attending:

Total for WOW4 Fees		Number Attending X Fees = $

Ticketed Event Fees
Reception (Thursday, June 4)	Fees	Number attending
Faculty/Professional	$25.00 per person
Grad/Undergraduate Students	$15.00
Conference Dinner (Saturday, June 6)
Faculty/Professional	$40.00 per person
Grad/Undergraduate Students	$25.00 per person
Total for Event Fees		Number Attending X Fees = $

Contribution to WOW4 travel fund (No commas or decimal points--just digits please)

Payment Method

Check(Check for yes)
Money Order(Check for yes)
Traveler's Check(Check for yes)
Payments can now be made by credit card. Credit cards that can be accepted are: Visa, Master Card, American Express, and Discover. Please check the checkbox below to pay by credit card. Credit Card(Check for yes)

Total Amount of Payment (WOW4 and Event Fees)		$
Payment for WOW4 registration and event fees should be made payable to Indiana University.
Payment is due at the time of registration for all participants in the U.S. If registering online, please mail payment to Carol Buszkiewicz (see address below) within 10 days of registering. Please do not send cash.






Please mail check to:

Carol Buszkiewicz Workshop in Political Theory and Policy Analysis Indiana University 513 North Park Avenue Bloomington, IN 47408-3895
Conference registration receipts will be sent by email when payment has been received.

* * * * *

Workshop in Political Theory and Policy Analysis Indiana University,
513 North Park Avenue
Bloomington, IN 47408-3895 USA
Ph: 812.855.0441/Fax: 812.855.3150
Email: wow4@indiana.edu
Website: http://www.indiana.edu/~workshop
Email:
Website: http://www.indiana.edu/~wow4

by
Copyright 2009, The Workshop in Political Theory and Policy Analysis