Registration Form-Vendors

Conference on Current Pagan Studies
January 23 & 24, 2016

Registration form- Art Show, Vendors, Posters
Submission Deadline: January 5, 2016

Name
Prefix

First

Last

Suffix

Institution/ Business

Independent Artist

Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Phone (Day)

###		 -
###		 -
####
Phone (Evening)

###		 -
###		 -
####
Email

Artist_____ Describe Work/ Medium
Vendor____ Describe Product(s)
Poster____ Title/ Description
Fees: Includes Coffee and pastries at Registration , Conference & Lunch
Claremont Consortium Students: $15 ($10 for Early Bird)
Students: $45
Professors: $70
Others: $55
$10 Discount for Early Bird (other than CC students) - Ends November 15,2014
SAVE MONEY & GREEN THE CONFERENCE-
Bring Coffee cup- Reduce fee by $2.50
Bring Plate- Reduce fee by $2.50
Bring Both- Reduce fee by $5.00
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