June 21-24, 2007 at Hiram College

Name______________________________________

Address ________________________________________________________

________________________________________________________

________________________________________________________

Email ____________________________

Telephone_____________________________

I will attend the symposium ____ I will submit a paper for consideration___

I would like more information about the graduate course connected to the symposium

(June 18-24)_____

I will stay on campus. Reserve a room for me _____

Non-commuters at the symposium will be housed in an air-conditioned dorm on Hiram’s campus (Space is limited, however, so early registration is recommended.)  Registration fee for the symposium is $195 by 6/1/07 , $245 thereafter. Fee for room and board is $240 by 6/1/07 , $290 thereafter. Combined fees,  ($435 by 6/1/07 ; $535 thereafter; Commuters--Registration ($195 by 6/1/07, $245 thereafter .)  Fee for board only is $120 by 6/1/07, $145 thereafter. Combined fees, $315 by 6/1/07, $390 thereafter.) For more information, please contact Teddie Joeright at Joerightta@Hiram.edu or call 330-569-5380.  

Please make checks payable to Hiram College or fill out credit card information.  If you would rather call your credit card information in, contact Beverly Sorrick at 330-569-5117.

Please bill my (circle one) Visa Mastercard Discover Other

Amount to be billed $__________________

Name as it appears on my account:_____________________________________

Account Number_______________________________________

My account number expiration date_______________________

Signature________________________________________________

Mail to: Mahan House, Hiram College , Hiram OH 44234