Bridgewater College | Poetics Conference Registration

Poetics Conference Registration

Please fill out all applicable fields ( Fields marked with _*are required )
_*First Name:
_*Last Name:
Preferred Title
Street Address:
City:
State:
Zip:
_*Email:
_*Phone:
Institutional Affiliation:
Department:

_*Registration Fee: (Please choose one.)
	Faculty/professional presenter, panel chair, or attendee, $85
	Guest of registered conference participant (meals only), $60
	Student (with meals and breaks), $60
	Student (neither meals nor breaks), $10

_*Please check the line that best describes your ability to attend
	My funding and visa are secure.
	My funding and/or visa are unverified, but I expect no problems.
	My funding and/or visa are unverified, and my attendance is uncertain.

Your registration fee includes the following food, but to help us plan and avoid waste, please indicate which you expect to attend:
Thursday, October 16 evening reception
Friday, October 17 morning break
Friday, October 17 lunch
Friday, October 17 afternoon break
Saturday, October 18 morning break
Saturday, October 18 lunch
Saturday, October 18 afternoon break
_*The Banquet on Friday evening will be $25; please choose the number of attendees for whom you wish to pay (Including yourself - banquet is not included in Conference fee).
Please indicate any dietary preferences, including vegetarian or vegan diet.

_*Are you a member of the Conference on Christianity and Literature? (All presenters must join.) (non-US, $35; US $25; students $20)
Yes No
Please see web page for links to join via Pay Pal.
On campus registration is scheduled to begin at 2 p.m., Thursday. If you know your expected time of arrival, please indicate it here by time and day. Include mode of travel and airport terminus, if applicable, and whether we may share this information with other participants who may be interested in sharing.

From what source did you learn about the conference?

Do you have any additional comments or questions?

_*Confirmation: An email confirmation of your registration will be sent upon receipt of payment. If you would like a hardcopy receipt included in your conference folder, please check here.
Yes No
- Total Due


Clicking the Submit button will take you to a page where you can verify your information and then continue to Paypal or obtain the mailing address to send a check for conference registration fees.
*******When you have completed your credit card transaction with Paypal (if applicable), please click the button in PayPal reading "Click here to complete your Conference registration."