2009 Conference Registration

Registration Form

Participant Information:

Name: __________________________________

Institution: __________________________

Address: _____________________________________________________________________

City: ___________________________________        State: __________

ZIP: ________________

Email: _______________________________________________________

Daytime Phone: _______________________________________________

Registration Fees:

_____ $80   Full Registration

_____ $60   Graduate Student Registration

_____ $22   Optional Luncheon (Saturday), including entrée, salad, vegetable, rolls, and dessert.

Please choose one entrée below.

_____ Pepper-rubbed Chicken in roasted onion marinara on flat pasta

_____ Applewood Smoked Brisket with sweet potato barbeque sauce

_____ Vegetarian: Portobella Filet with Argula and Manchego hash

$__________  Total Payment

Please mail your registration form and checks made out to the MWCBS to:

Professor Eric G. Tenbus

Department of History and Anthropology

Secretary/Treasurer MWCBS

Wood Hall 136H

Warrensburg, MO  64093



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