Registration Form

31st Annual ASCLD Workshop and Symposium

 Please complete one registration form per person
Once your registration form has been processed, you will receive a confirmation notice.
 Return registration form by Friday, September 12, with payment to:

 Institute for Law and Justice
ASCLD Workshop and Symposium
1018 Duke Street, Alexandria, VA  22314

Registrar Type      *
Salutation      *
First Name       *
Middle Initial     
Last Name       *
Job Title       *
Organization       *
Sub-Organization     
Division     
Sub-Division     
Street Address       *
Street Address     
City       *
State      * If No State, select ''No State''
Country      If U.S., leave blank
Postal Code       *
Work Phone       *
FAX       *
Home Phone     
Home Fax     
Mobile Phone     
E-Mail     
      Academic Member     Regular Member
      Retired Member     Emeritus Member
      Not a Member
Would you like to request the housing allowance for your laboratory?
      Yes     No
What are your hotel check-in, check-out dates?
Check-in:     
Check-out:     

If you have any special needs that should be addressed in order for you to fully participate in this meeting, please contact Margaret Black at the Institute for Law and Justice, margaret@ilj.org

Checks or purchase orders, made payable to ILJ, may be mailed (ILJ 1018 Duke Street, Alexandria, VA, 22314) or may be given on-site. To pay by credit card, print the faxable form and return to ILJ at 703-739-5533.

   

For additional information, contact ILJ at 703-684-5300 ([phone), 703-739-5533 (fax) or margaret@ilj.org.

 

The 32nd Annual ASCLD Workshop and Symposium is a contract managed by the Institute for Law and Justice.