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Binghamton, New York
June 7-9, 2001

Conference Registration Form

(Last updated: April 5, 2001 11:26 AM)
Registrant's Information (Please type or print, and check [X] where appropriate)

Title:

[   ] Mr.

[   ] Mrs.

[   ] Ms.

[   ] Miss

[   ] Prof.

[   ] Dr.

[   ] Student

[   ] Non-student

Last Name:

First/Middle Name:

Affiliation (for name badge):

Institution/Company/Organization

[   ] Same as above

[   ] Other

Department:

Mailing Address:

[   ] Office

 [   ] Home

City:

State:

Zip:

Daytime Telephone: (       )

Fax: (       )

Email:

[   ] I'll require hotel accommodation.
(Please make hotel reservation using the Hotel Reservation Form provided by May 17, 2001 to enjoy the conference discount rate.)

[   ] I would like to participate in the Post-Conference Outing to:
           [   ] Cayuga Wine Trail
           [   ] National Baseball Hall of Fame and Museum

[   ] I would like to purchase a 3-day parking pass at $3 per car.

Signature:

 Date:

Registration Fee enclosed: $           (Registration: US$100 per person. Parking Pass: $3)

(Please make check payable to: Binghamton Foundation 50330)

Please print the following form and mail it with payment to:
Center on Democratic Performance
Department of Political Science
Binghamton University
Binghamton, NY 13902-6000