I-ASIST Logo, a shaded light blue image of the state of Indiana, 
with the text - ASIST - centered within the image
The Indiana Chapter of the Association for
Information Science & Technology (I-ASIST)

"Success Strategies for Landing Your First Library Position"
2007 Spring Program    
l     26 April 2007     l   Indianapolis, IN, USA

Registration Form

Registration Deadline:        Tuesday, 17 April 2007     

 Note: Items in RED are required

Title:  Mr. Ms.  

 

Last/Family Name:

First Name:


ASIS&T Member #:
(if unsure, please e-mail membership@asis.org)

 


Organization:


Address:


City:


State/Province:


Zip+4/Postal Code:
/


Country:


Telephone:


Fax:


E-Mail:

Please send my registration confirmation to: postal address; email address  

Badge Information. Please provide below the information as it should appear on your name badge.

Your Name:

Location:

Organization Name:


Program Registration Fees (Please submit one form per person attending.)

ASIS&T Member

  $35

Non-Member

  $45

Student Member

  $25

Student Non-Member

  $40

 

Save Money! Students can join ASIS&T & for a one year membership and attend this event for only $65: http://www.asis.org/Join/index.html

 

        I will require Americans with Disabilities Act special assistance onsite.  Please give details below.
        I will require special dietary assistance.   Please give details below.
      Comments:

Method of Payment

Payment Type:

Card Number:

Expires:

Signature: ___________________________________________
                             (only required if faxing or mailing)

Check enclosed(Make check payable to Indiana ASIS&T; if Non-Member Student, please also send copy of student ID)

Note: Your credit card will be transmitted via a secure server directly to ASIS&T Headquarters and your browser should display the closed lock icon when you submit your registration information.

To Fax CREDIT CARD PAYMENTS: Print registration form and fax to ASIS&T headquarters: (301) 495-0810.

To Fax CHECK PAYMENTS: Print registration form and fax to Steve Hardin, I-ASIST Member Liaison: (812) 237-2567.

Mail*: Print registration form and mail check and form (payable to Indiana ASIS&T; if Non-Member Student, please also send copy of student ID ) to:

    Steve Hardin, I-ASIST Member Liaison
    Cunningham Memorial Library
    Indiana State University
    Terre Haute, IN 47809
*Please email to let us know you mailed it for our numbers count:

Cancellation Policy: All payments must be received by the registration date indicated. Full refunds will be given for any cancellations prior to that date. Indiana ASIS&T reserves the right to invoice registered individuals who do not cancel within the specified time period. Please e-mail or phone: 574-631-3409 your cancellation.


Association for Information Science and Technology
8555 16th Street, Suite 850, Silver Spring, Maryland 20910, USA
Tel. 301-495-0900, Fax: 301-495-0810 | E-mail:
asis@asis.org

ASIS&T Home Page

Copyright © 2007, Association for Information Science and Technology