CONFERENCE 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
Your registration fee covers the opening conference reception, four lunches, three continental breakfasts, entrance to all general and keynote sessions, and conference materials.
Conference Participant
Early Registration: $250 (postmarked by March 24, 2002) / $300 after March 24 .....$__________
Conference Wind-up Event: $20 .................................................................................$__________
Guest Tickets
Opening Reception: _____ guests x $28 ......................................................................$__________
Wind-up Event: _____ guests x $32 ............................................................................$__________
Total Payment for Participant and Guests ............................................................. $__________
Make your personal and/or institutional check(s) payable in US dollars to Assessment Conference 2002. The federal tax id # is 72-1505869.
Complete and mail this form together with payment to:
Louise Miura
University of Hawaii at Manoa
2600 Campus Road, SSC 406D
Honolulu, HI 96822
Cancellation Policy
A $50.00 fee will be assessed for all cancellations by March 24, 2002. Cancellations after March 24 will be subject to a 50% assessment.
NOTE: if you or your guest(s) have special dietary restrictions, please list them below.
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