registration Sample – Conference of Southern Graduate Schools

Institution: (required)

Contact Name: (required)

Contact Email: (required)

Contact Telephone: (required)

Contact Address: (required)

City: (required)
State Abbreviation: (required)
Zip: (required)

For each event below, please indicate the number of attendees, and their names and titles. Badges will be printed with the names and titles listed here.

Note: If you are a student who is not participating in 3MT event, but wish to attend the conference please use the Student Registration Section.

Registration

1 or 2 attendees
$400 each, until December 15, 2018
$475 each, after December 15, 2018

3 or more attendees
$350 each, until December 15, 2018
$425 each, after December 15, 2018

Number of Registrants: Name,Title,Email and Dietary Preference and Food Allergies(if any) of each Attendee:
example:John Doe, Associate Dean, abc124@college.edu,Vegan,None

Name	Title	Email	Dietary Preference	Allergies (if any)

One day-Registration

1 day registration
$150 each, until December 15, 2018
$175 each, after December 15, 2018

2 day Registration
$300 each, until December 15, 2018
$350 each, after December 15, 2018
Note: If registering for 3 or more days, please use registration section above

Number of Days:
Name,Title,Email,Dietary Preference and Food Allergies(if any) of each Attendee:
example: Joe Smith, Graduate Student,abc@college.edu,Allergic to peanuts

Name	Title	Email	Dietary Preference	Allergies (if any)

Student Registration
$150 each, until December 15, 2018
$175 each, after December 15, 2018
Note: Each student has to register separately, no group registrations allowed.

Name,Title,Email,Dietary Preference and Allergies(if any) of Attendee:
example: Jane Smith, Graduate Student,jzs0012@college.edu,Vegan,NONE

3MT Participation
$100 each

Number of Attendees:
Name,Title,Email address and Institutional 3MT Contact of each Attendee:
example: John Doe, PhD Candidate, College of Business,
abc123@school.edu, Dr. Smith,xyz0010@school.edu

Name	Title	Email	Dietary Preference	Allergies (if any)

Joint Reception Guest Ticket
$50 each

Number of Attendees:
Name,Title,Dietary Preference and Allergies(if any) of each Attendee:
example: John Doe, Guest,Vegan,NONE

Reception Guest Ticket
$50 each

Number of Attendees:
Name,Title,Dietary Preference and Allergies(if any) of each Attendee:
example: John Doe, Guest,Vegetarian,NONE

Guest Breakfast Ticket
$50 each

Number of Attendees:
Name,Title,Dietary Preference and Allergies(if any) of each Attendee:
example: John Doe, Guest,Vegan,Allergic to Nuts

Guest Awards Luncheon Ticket
$40 each

Number of Attendees:
Name,Title,Dietary Preference and Allergies(if any) of each Attendee:
example: John Doe, Guest, Vegan, NONE

Please include any notes or comments here.