Register Name * First Name Last Name Title/Position * College/University * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Country (###) ### #### Email * I will attend the Saturday Night Banquet * Yes No Dietary Restrictions/ Food Allergies (Please specify) * (e.g. Vegetarian, Gluten-Free, Nut Allergy) I would like to serve as a session moderator * Yes No I would like to present a paper Yes No Please let us know if you require any accommodations (e.g. wheelchair access, ASL interpreter Thank you!