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Conference Registration Form Center on Democratic Performance Binghamton University, State University of New York Binghamton, New York June 7-9, 2001
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.
Other comments:
Signature:						Date:
Registration Fee enclosed: $
(Registration: US$100 per person. Parking Pass: $3 per car) (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