KCA 78th Annual Conference Registration Form

"BE THE CHANGE"

First Name:
Last Name:
Institutional Affiliation:
Address1:
Address2:
City:
State:
Zip:
Phone: e.g., 8595551111 (no hyphens or parentheses please)
E-mail:
Membership Rates
KCA Membership Fees (for individuals NOT attending the Conference)
  Annual Membership Dues Only (includes journal)
$30.00
  Student Annual Membership Dues Only (includes journal)
$20.00
  Emeritus Annual Membership Dues Only (includes journal)
NO MEMBERSHIP FEE
Membership and Conference Registration Rates
KCA EARLY BIRD Pre-registration Conference Package
(Register BEFORE August 1, 2009)

Includes membership dues, journal subscription, conference fee, and meals

  Emeritus EARLY BIRD Registration Conference, Meals & Dues
$55.00
  Students EARLY BIRD Registration Conference, Meals & Dues
$75.00
  Members EARLY BIRD Registration Conference, Meals & Dues
$85.00
  Non-Members EARLY BIRD Registration Conference, Meals & Dues
$100.00
KCA LATE Registration Conference Package
(AFTER August 1, 2009)

Includes $10 LATE FEE, membership dues, journal subscription, conference fee, and meals

  Emeritus LATE Registration Conference, Meals & Dues
$65.00
  Students LATE Registration Conference, Meals & Dues
$85.00
  Members LATE Registration Conference, Meals & Dues
$95.00
  Non-Members LATE Registration Conference, Meals & Dues
$110.00
Conference Family Member / Guest Meal Package
(Add $41.24 per guest for 3 catered meals)
Number of additional guests attending Friday Picnic Dinner ($12.98 per person)
[Field:'picnicAmountDue']
Number of additional guests attending Saturday Breakfast Buffet ($10.62 per person)
[Field:'breakfastAmountDue']
Number of additional guests attending Saturday Keynote Luncheon ($17.64 per person)
[Field:'keynoteAmountDue']
     
TOTAL AMOUNT DUE:
$[Field:'TotalDue']