Registration Form

Seventh Annual

Not Another Statistic Conference

November 7-8, 2014

REGISTRATION FORM

Note: Form fields appended with the asterisk (*) are required to ensure the best possible response to your submitted information

REGISTRATION FORM

*Institution
*Contact Person
*Title
*Mailing Address
*Phone
*Fax
*E-mail

REGISTRANTS

Register each of the attendees from your institution below. Please be sure to indicate if there are any ADA accommodations or dietary needs necessary while in attendance at the conference. The registration fee is $50 and the deadline to register is Friday, October 31, 2014.

The conference is free for University of Mount Union students with no meals being provided.

Registrant 1
TESTADA Accommodations or Dietary Needs for Registrant 1
Registrant 2
ADA Accommodations or Dietary Needs for Registrant 2
Registrant 3
ADA Accommodations or Dietary Needs for Registrant 3
Registrant 4
Special AccADA Accommodations or Dietary Needs for Registrant 4ommodations for Registrant 4
Registrant 5
ADA Accommodations or Dietary Needs for Registrant 5
Registrant 6
ADA Accommodations or Dietary Needs for Registrant 6
Registrant 7
ADA Accommodations or Dietary Needs for Registrant 7
Registrant 8
ADA Accommodations or Dietary Needs for Registrant 8
Registrant 9
ADA Accommodations or Dietary Needs for Registrant 9
Registrant 10
ADA Accommodations or Dietary Needs for Registrant 10
Registrant 11
ADA Accommodations or Dietary Needs for Registrant 11
Registrant 12
ADA Accommodations or Dietary Needs for Registrant 12
Registrant 13
ADA Accommodations or Dietary Needs for Registrant 13
Registrant 14
ADA Accommodations or Dietary Needs for Registrant 14
Registrant 15
ADA Accommodations or Dietary Needs for Registrant 15
Registrant 16
ADA Accommodations or Dietary Needs for Registrant 16
Registrant 17
ADA Accommodations or Dietary Needs for Registrant 17
Registrant 18
ADA Accommodations or Dietary Needs for Registrant 18
Registrant 19
ADA Accommodations or Dietary Needs for Registrant 19
Registrant 20
ADA Accommodations or Dietary Needs for Registrant 20

*Number of Registrants x $50 = (if you are a Mount Union student, use a 0)
*Amount Owed (if you are a Mount Union student, use a 0)

Please submit this registration form by clicking the button below. Registration fees should be mailed to Karen Saracusa, Director of Student Accessibility Services at the University of Mount Union, 1972 Clark Avenue, Alliance, Ohio 44601 no later than Friday, October 31, 2014. Please make check payable to University of Mount Union. Registration fees can also be paid by credit card after submitting this form. Payment must be received before the conference dates.

Security Check

Please leave this field incomplete