| Name: |
_____________________________________________ |
| College: |
_____________________________________________ |
| Address: |
_____________________________________________ |
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_____________________________________________ |
| Phone: | _____________________________________________ |
| E-mail: | _____________________________________________ |
| Home Address: | (Only if you wish your conference registration confirmation mailed to your home.) |
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_____________________________________________ |
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_____________________________________________ |
| Status: | Full Time ______ Part Time ______ |
| CEI Member? | Yes ______ No ______ |
| I plan to join or renew now for $15.00 ______. Note: Membership is renewable each year at the time of the fall conference. Adjunct faculty pay no dues. |
CONFERENCE FEES
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| Registration: | _____ $20.00 (includes all sessions listed on the program, two snacks daily, NC Poet Laureate reading and reception Sunday, and hospitality room. |
| Member dues: | _____ $15.00 |
| Non-member: | _____ $35.00 |
| Motel: | _____ $70.00 Note: The charge is daily per person (sleeps 2) and includes all meals Sunday dinner through Tuesday lunch. Only 20 rooms available (40 persons), first come, first served. |
| Cabin: | _____ $55.00 Note: The charge is daily per person (sleeps 4) and includes all meals. |
| Sunday only: | _____ $23.00 Note: The charge includes Sunday dinner and reception. |
| Weekday only: | _____ $20.00 Note: The charge includes lunch and two snacks. |
| TOTAL ENCLOSED: | ______ |
| Please indicate: | ______ Special Diet ______Vegetarian |
Return this registration form and your check made out to CEI by September 10 to
Thomas LaBelle, CEI Secretary/Treasurer
Central Carolina Community College
1105 Kelly Drive
Sanford, NC 27330
(919) 718-7224
No refunds after September 10, 2002, unless the room can be re-assigned.
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