Registration Form by Check

Mail In CRWAD Meeting Registration Form

Must be postmarked by November 11 for pre-registration
Pre-Registration Will Close November 11

Register by mail and send a check with your completed registration form. You may also print this form and email it to Dr. David Benfield.


Please print this form, fill it out, and send it with payment to Dr. David Benfield.
Make check payable to CRWAD. Send payment to Dr. David A. Benfield, CRWAD, 1680 Madison Avenue, Research Services Building Room 209e, Ohio State University, Wooster, OH 44691.

Please type or print the following information:

Name:_______________________________________________________________________________

Affiliation:____________________________________________________________________________

Department of Affiliation: ________________________________________________________________

City:_________________________________ State:________ Zip/Country:_________________________

Phone:_______________________________________

E–mail: (type or print)____________________________________________________________________


Please note: You are not a member until you have applied for membership and the Council has granted membership. Non-members must register as either a guest, or a post–doc, or a fulltime student.

Approved Member Registration: $140 (includes Program); Registration after November 11th $170.00
 
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Member:  2017 Dues $70.00 (Dues do not cover registration)

 

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Unpaid Dues: $70.00 per past year

 

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Fulltime Student/CRWAD Student Member: $70.00 (includes Program) 
Student ID will be required when you pick up your name badge. 
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Post–Doc or Resident: $90.00 (includes Program)
ID will be required when you pick up your name badge. 
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Guest and/or Member Applicant: $345.00 (includes Program); Registration after November 11th $375.00
 
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Proceedings Booklet (includes Abstracts and Program): $35.00 at on–site
$40 if mailed to North America;
$50 if mailed to outside of North America
 
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Total Amount Due (US funds only):
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*REFUND POLICY: Registration fee full refund,less $50, if requested within 45 days of annual meeting; 50% refund from 44 – 22 days before annual meeting; no refund if requested 21 days or less before annual meeting.

Presenters and attendees will be required to wear their CRWAD name badge for admittance to the meeting rooms and poster sessions. Presenters must be registered for the meeting and will be required to wear their CRWAD name badge during their presentations.

If you would like to present at the Annual CRWAD Meeting or would like an invitation to the meeting please contact Dr. David A. Benfield.

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