Conference Registration

Please complete and submit the form below by April 15, 2008

Conference Registration     Name:  College or University:  Mailing Address:  Home Phone:  Alternate/Cell Phone:  E-mail Address:  Paper and Poster Registration   Title of Presentation (limited to 100 characters including spaces)

Abstract of Presentation (limited to 250 words)



Submission Format Preference:

Paper

Poster

Lodging Registration

Are you requesting lodging for the conference? 

Yes

No

What is your gender? (for roommate purposes) ? 

Male

Female

Do you need a smoking room? 

Yes

No

Do you need special room accommodations for any reason, e.g., physical disabilities?

Yes

No

If so, please explain.


Do you have a preferred roommate?

Yes

No

If so, what is his/her name?


Do you have any food allergies or Dietary Restrictions?

Yes

No

If so, please explain.

     

All registration fees must be paid by check or money order.  Please make all checks or money orders payable to the BLACK STUDENTS PSYCHOLOGICAL ASSOCIATION.  Place name of participant in the memo section of check or money order.  Please print a copy of this page and send it along with your registration fee to:

National Black Graduate Conference In Psychology
East Hall
Department of Psychology
University of Michigan
Ann Arbor, MI 48109-1109