NAME:
_______________________________________________________________________
AFFILIATION
(if applicable): ______________________________________________________
(Please
give name and affiliation as you want them to appear on your name tag)
MAILING
ADDRESS: _____________________________________________________________
EMAIL
ADDRESS: _______________________________________________________________
PHONE:
_______________________________________________________________________
ARE
YOU A SYMPOSIUM PRESENTER? Yes No
The
following questions are optional, intended only to assist us in planning the
event. They do not commit you in
any way.
Do
you plan to make use of the parking facilities at the Kentucky Building? Yes No
Do
you plan to attend the Thursday
reception at the Kentucky Building, 4:30 PM (opening of the photography
exhibit and panel discussion on bluegrass and the Station Inn?) Yes No
Following
Neil RosenbergÕs keynote address on Friday evening, do you plan to attend
the reception / picking party
hosted by ASCAP at the Holiday Inn? (You need not be staying at the hotel to
attend) Yes No
If
limited shuttle service were available between the hotel and the Kentucky
Building, would you be likely to make use of it? Yes No
Do
you have ADA or similar needs/ limitations? _____________________________________
Registration
fee (circle one): Regular $75 | Full-time student $55
Payment method (circle one): Check | Credit Card
If paying with credit card, select one: VISA | MasterCard | Discover
Name as it appears on the card ________________________________________
Expiration date: ________________________________________
Signature ________________________________________
Date ________________________________________
Please
print out this form and send it with a check for your registration fee by
August 16 to:
THE
BLUEGRASS MUSIC SYMPOSIUM
Department
of Folk Studies and Anthropology
Western
Kentucky University
1
Big Red Way
Bowling
Green, KY 42101