PCEA 2010 Conference Registration Form

Please Note: This form is designed to be PRINTED OUT and used for regular postal mailing.

ALL presenters and attendees are REQUIRED to register. Please print out all pages of this form.  Fill it out completely, and then mail it by March 10th to the address below:

Dr. Gay Chow
Department of English
110 Leonard Hall
Indiana University of Pennsylvania
Indiana, PA 15705-1094

Name: ____________________________________________ Institutional Affiliation: _______________________ Professional Status: ___ Undergraduate Student ___ Full-Time Faculty ___ Graduate Student ___ Retired Faculty ___ Part-Time Faculty ___ Other (please list): __________________ Conference Status: ___ Presenter ___ Session Chair ____ Attendee Only ___ First Time Presenter/Attendee Mailing Address: _________________________________________________________ _________________________________________________________ Phone: __________________________________________________ Email: __________________________________________________ Scholarship & Teaching Interests: _________________________________________________________ _________________________________________________________ Would you be interested in occasionally reviewing article submissions for PCEA's journal, Pennsylvania English? Yes _____ No ____ Title of Presentation (if presenting): __________________ _________________________________________________________ _________________________________________________________ Audio Visual Needs (if presenting): _________________________________________________________ _________________________________________________________ Fees: PCEA Presenters are required to become members of the PCEA organization. Conference attendees are also encouraged to join the organization. Membership in PCEA includes a subscription to the journal Pennsylvania English. Membership fee enclosed: ______ $30 Faculty, $40 Joint, $15 Student/Retired Registration fee enclosed: ______ $45 Faculty Advance Registration ($55 on-site) ______ $20 Students/Retired     Lunch Menu Please select an entrée for lunch, which will be followed by our keynote address. ____ Chicken ____ Vegetarian Included with all entrees: choice of beverage (coffee, tea) _____ $15 Luncheon fee Summary of Fees Included: Membership Fee _____ Registration Fee _____ Lunch Fee _____ Total _____