Information as it should appear in the conference program.

*Note:  Please do not press the 'ENTER' key to move between questions, use the 'TAB' key or your mouse to move between questions.  Pressing the ENTER key will take you back to the start of the form.

STUDENT/STAFF

ID NUMBER:

NAME:

INSTITUTION:

TITLE OF PAPER:

Unless pre-arranged, papers are to be limited to 20 min.

EMAIL:

Registration fees are $95; $65 for part-time faculty and graduate students; and $20 for undergraduates.

The Conference Registration Price:

Will you be attending the Thursday evening reception?

Will you be attending the Conference Banquet Friday evening? ($39)

Banquet Price:

Banquet Guest Name ($39 each):

Banquet Guests:

Please indicate any special equipment you may need:

How did you hear about the conference?

Would you be willing to serve as a Session Chair?

May we videotape your presentation?

Are you interested in sharing a ride with other participants?

If so, please give your tentative arrival / departure date

Return and Refund Policy:

Conference registration fees are non refundable.

About the payment site:  The University of Virginia's College at Wise employs Hosted Payment Pages a product hosted by Nelnet Business Solutions, as a means of providing a secure online payment application for departments that provide goods or services; manage events and conferences; or collect billed receivables. Hosted Payment Pages was selected to help assure the security of your data. The system is Payment Card industry Data Security Standard (PCI-DSS) Level 1 compliant and utilizes encryption to further protect all end to end communication.

We encourage our users to remember that, for your protection, you should consider the security on any device or computer that you are using to process an electronic payment on the internet safely. Be cautious about using public computer terminals.

Customer Service Contact Information:

Contact Name: Kenneth Tiller 
Contact Phone and/or Email:  276-376-4587    kjt9t@uvawise.edu

Commitment to Privacy:

Individuals’ privacy is important to the University of Virginia's College at Wise. To better protect your privacy we provide this notice explaining our online information policy and practices. To make this notice easy to find, we make it available through a link on our homepage. Our privacy and public records obligations are governed solely by applicable Virginia statutes, including, but not limited to, the Virginia Privacy Protection Act of 1976, the Virginia Freedom of Information Act, and by any applicable U.S. federal laws. The entire policy can be found at https://www.uvawise.edu/privacy-statement/.