PERSONAL INFORMATION: |
| The way you enter your name is how
it will be printed on your name tag. |
| First Name: |
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| Last Name: |
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| School
Name: |
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| Address: |
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| Address: |
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| Address: |
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| City: |
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| State: |
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| Country: |
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| Zip: |
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| Phone: |
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| Email: |
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Please check all that apply |
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REGISTRATION FEES:
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$250 - NCSM
registration and payment received by February 25th. Registration
includes:
· Your conference
registration
· 2009 NCSM Proceedings
· Thursday Dinner Cruise
on the Elizabeth River, 6:30 pm -9:00 pm. Includes two
drink tickets for wine or beer, complete dinner and a
cruise. Co-sponsored by USCA, Valpak and NCSM.
· Lunch on Friday
· One year’s subscription
to JPSSM
o If you are a
current subscriber to JPSSM, your subscription will be
extended one year.
o
NOTE: There is an additional $16 fee for mailing JPSSM
to non-US addresses. You must add this to your registration.
Please provide your full address to where you want JPSSM
sent.
All payments must be made
in US dollars. |
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$275 - NCSM
registration and payment received after February 25th.
Registration includes:
The same as listed above
All payments must be made in US dollars. |
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$0 - Doctoral
Student Registration - All doctoral students
must complete and submit a registration form.
Registration includes:
· Your conference registration
· 2009 NCSM Proceedings
· Thursday Dinner Cruise on the Elizabeth River,
6:30 pm -9:00 pm. Includes two drink tickets for wine
or beer, complete dinner and a cruise. Co-sponsored by
USCA, Valpak and NCSM.
· Lunch on Friday |
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$0 - I will
be attending NCSM, but have already registered for the
full Pi Sigma Epsilon Convention with PSE National Headquarters.
Registration includes:
· Your conference registration
· 2009 NCSM Proceedings
· Lunch on Friday
You will need to pay for the Dinner Cruise separately.
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$60 - Discounted JPSSM
one-year subscription for Doctoral Students or full PSE
Convention registrants. All non-US residents must add
an additional $16 for shipping and handling. |
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$16 - Additional JPSSM
shipping fee for non-U.S. resident |
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$60 - Dinner Cruise on the Elizabeth River, Thursday, March 26th, 6:30 pm – 9 pm. Includes two drink tickets, complete dinner and a cruise. This is for guests and spouses of NCSM attendees or those that registered for the PSE Convention. |
PAYMENT INFORMATION: (Leave blank if your registration
fee equals $0.00)
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Payment
will be mailed Check |
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| Credit Card: |
Visa
Mastercard
American Express |
| Credit Card Number: |
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| Card Expiration: |
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| Name on Card |
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Reserve
your hotel room for the conference online - http://cwp.marriott.com/orfws/pse
or call 1-800-874-0264 and say you are with PSE to get the group
rate.
The Program Chair for NCSM 2009 is Dr. Mark Johlke of Bradley
University (mjohlke@bradley.edu),
and any questions about the Conference should be directed to
him.
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