2002 KPSA PRE-REIGISTRATION FORM
March 1-2, 2002
Cumberland Inn, Williamsburg, KY

Please return this as soon as possible, that we may get a reasonably accurate count for dinner.  If you do not wish to register at this time, but DO plan to attend the dinner, please inform Bruce Hicks by mail (address below), e-mail (bhicks@cc.cumber.edu), or telephone (606-539-4267).

NAME      __________________________________________________

SCHOOL  __________________________________________________

E-MAIL    __________________________________________________


Item
Cost
Number
    Total 
Regular Registration (includes membership fee) $12.00    
Student Registration (free membership) $8.00    
Dinner $20.00      
    Total Payment:   
(Make Checks Payable to: Kentucky Political Science Association)
PayPal users send payment from your account, with a note of explanation, to kpsa@mailbox.as.

Note below additional attendees registered on this form:

Name
School
Regular/Student
email
       
       
       
       
       
       
       
       
       

 Return to:
  Dr. Bruce Hicks, KPSA
  History and Political Science Department
  Cumberland College
  7301 College Station Drive
  Williamsburg, KY 40769