Registration Form

Phi Alpha Theta Regional Conference

University of Dayton

March 21, 2009

Name:

School:

Circle one:        student             faculty

If student:

Circle one:        undergraduate               graduate

Circle one:        PAT member                non-member

Title of paper (just to make sure it is correct in program):

The student chapter at UD is planning a social event for the evening before the conference.  They need to have an idea of how many people may be coming in on Friday and would be interested in attending the social event (7:00 p.m. – 10:00 p.m.) on campus. 

Yes      No       I am planning on attending the social event on Friday evening.

The cost of the conference is $10 per person -- checks only as we are unable to accept credit card payments.

So that we can finalize the catering order, we ask that all participants – student and faculty – register by March 6, 2009.

Checks should be made out to:  University of Dayton

Checks and the registration forms should be sent to: 

Dr. Janet R. Bednarek, Department of History, University of Dayton, 300 College Park, Dayton, OH 45469-1540.