David Loberg Code, School of Music, Western Michigan University, Kalamazoo, MI, 49008. E-mail: code@wmich.edu
http://www.wmich.edu/mus-theo/mtmw98/98_reg.html Revised: 2.Apr.98
Name (to appear on name tag) _____________________________________________________
Academic Affiliation __________________________________________________________
Faculty [ ] Student [ ]
Mailing Address ______________________________________________________________
City/State/Zip ________________________________________________________________
Is this a change of address? NO [ ] YES [ ]
Telephone (w)_____________________________ (h )______________________________
E-mail address ________________________________________________________________
Registration Fee...................................................................................................... $__________
Before 4 May: MTMW Member $15.00; Non-Member $25.00; Student $8.00
After 4 May:
MTMW member $20.00; Non-Member $30.00; Student $13.00
| Luncheon Pasta Buffet (Saturday, 16 May, 12:00 noon): | ||
| _____ persons @ $12.95........................................................................ $__________ | ||
Dessert Party at the Home of Anne Marie de Zeeuw (Saturday, 8 PM)
_____ persons
Total Amount Enclosed (Check payable to "MTMW")........................... $___________
Mail check along with this completed registration form to the following address.
Your canceled check will serve as your receipt.
Rebecca Jemian
MTMW Registration
School of Music
University of Louisville
Louisville, KY 40292
http://www.wmich.edu/mus-theo/mtmw98/98_reg.html Revised: 2.Apr.98