Registrant Details (required fields) |
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Name |
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Title/Department |
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School/Affiliation |
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Mailing Address 1 |
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Mailing Address 2 |
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City |
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State
Zip
Country |
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Phone (home) |
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Phone (cell/mobile) |
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Email |
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Student? (yes or no) |
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Photo Release |
We will have a
photographer in attendance at the conference. Candid photos will
be taken to be used for purposes such as Academy membership
brochures, the Academy website, etc. If you object to your
image being used for these purposes, please indicate at right. |
You may use
my image
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Registration Fees
Registration Fees (includes annual Academy membership fee &
most meals from
Thursday supper to Saturday lunch.) Select all options that
apply.
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I am paying my
fees by:
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