Registration Form                                < Back

Instructions:

(if you are a presenter you do not need to also do this form, your submission form suffices)

Select the below text in the box and paste into an email and

Return to urpcu -at- yahoo.com (replace “-at-” with “@”)

Put the text     URP Registration      in your email’s subject line to assist us.

Alternatively you can print and fax us your information. Fax to: +662 218-4582.

For questions contact us via email.

Registration form for URP’s Forum

Location: TBA, but on campus

Last Name (Family):

First Name (Given):

Title (Mr. Ms. Dr.):

Position (Prof. Director, Grad Student etc.):

Institution:

Country:

Mailing address:

Contact phone:                                                 Fax:

Email address:                                                  Website:

I can attend the Forum: All days: yes no

I can attend only the first day: yes no

I can attend only the 2nd day: yes no

I cannot attend the Forum, but Mr. / Ms.                                   can attend as my representative