SECM Bethlehem Registration

Conference Registration — Bethlehem 2014

You can use this online form to register for the Bethlehem conference as well as to sign up for various optional events and to make a donation to the Sterling E. Murray Student Travel Fund.

Payment for online registration is via Paypal or with a credit card.

If you prefer to pay by check, please print out and mail this form with payment.

Your Information
Required fields are marked with an asterisk (*).

Salutation:
First Name: *
Last Name: *
Address (Line 1): *
Address (Line 2):
City: *
State: *
Zip/Postal Code: *
Country: *
Email: *
Phone: *
Registration Level
Level
Optional Items
	Pre-conference visit to Moravian Historical Society, Nazareth, PA: Thursday, Feb 27, 3pm ( $8 )
	Historical beer tasting: Friday, Feb 28, 5pm ( $7 )
Murray Award Donation Please consider making a gift to the The Sterling E. Murray Award for Student Travel. The Murray Award was established in 2011 to encourage students to attend the Society’s biennial meetings. The award consists of $500 to support travel expenses as well as a student membership in the Society for one year. More information about the award can be found here. Please donate in whole-dollar amounts.
$
Total Cost (USD)
$0.00
After clicking "Purchase", you will be redirected to PayPal to input your payment info. NOTE: A PayPal account is not required. If you wish to pay by credit or debit card, proceed with “Don’t have a PayPal account?” below the Paypal login box. Questions? Problems? Contact thomas.cimarusti@ttu.edu