REGISTRATION FORM
Please type or print
Name______________________________________ Title____________________________________
Institution________________________________ Name on Name Tag__________________________
Address________________________________City/State/County/Zip__________________________
Work Phone____________ Home Phone___________ Fax____________ E-mail_________________
Conference Registration Fee (all fees to be issued in US dollars)
Your registration fee covers the opening conference reception, daily continental breakfast,
daily lunch, entrance to all general and keynote sessions, and conference materials.
Early Registration: $225 (postmarked by May 4, 2001)..............................................$__________
Registration after May 4, 2001: $275 .........................................................................$__________
Conference Wind-up Event: $25 ................................................................................$__________
Guest Tickets
Opening Reception......................_____ persons x $25 .............................................$__________
Wind-up Event............................_____ persons x $25 .............................................$__________
Total Amount ................................................................................................US..... $__________
Please make your check payable in US dollars to Caribbean Assessment Conference.
No purchase orders or credit card payments are accepted!
Complete and mail this form together with payment to:
Larry H. Kelley
c/o The University of Louisiana at Monroe
700 University Avenue, Library - Room 612
Monroe, LA 71209
CANCELLATION POLICY: A $50.00 fee will be assessed for all cancellations by May 4, 2001.
Cancellations after May 4 will be subject to a 50% assessment.
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