MAACBA: Online Registration Form

   
 
Registration Fee for the MAACBA Conference before September 14, 2012 is:
  • Members: $250 ($300 Members after September 14th, 2012)
  • Non-Members: $350 ($400 Non-Members after September 14th, 2012)

After submission of this form, payment can be made using the RMU ePay service.
 
E-mail:*
First:* MI:   Last:*
Address:*
City:*
State:*
Zip Code:*
 
Phone:
Institution:
 
Registration:
Member $250 ($300 Member after September 14th, 2012)
Non-member $350 ($400 Non-Member after September 14th, 2012)
 
 
 
Electronic Signature:* By checking this box, I hereby make my electronic signature. I have read and agree to all of the conditions of the electronic signature.
 
 
Notes/Comments:  
Conditions of electronic signature:
  • To the best of my knowledge, all of the information submitted via this form is correct and complete.
  • I am not attempting to gain access to, or modify, another person's account or personal information without their expressed permission.
  • Any misrepresentation will be deemed just cause for any of the following:
    • Collegiate Judicial Hearing
    • Dismissal from the University
    • Legal prosecution
 
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