2008 Membership and Conference Registration Form

Name Business Address Department College or University City/State/ZIP Phone Fax E-mail (We will use this only for conference and membership announcements, no junk.) Home Address Street City/State/ZIP Phone Fax E-mail (We will use this only for conference and membership announcements, no junk.) Circle one if applicable: Student Retired Unemployed Fees Note: Fees can be paid online through Acteva. If you register online, you do NOT need to mail in the paperwork, too. The deadline for either form of registration remains the same. Registration Fee: $_____ ($95 for faculty and other professionals; $75 for student, retired, or unemployed; must be postmarked by September 15, 2008, to avoid late fee) Membership Fee: $_____ ($65/year for faculty and other professionals; $45/year for student, retired, or unemployed; membership is for calendar year 2008 but must be postmarked by September 15, 2008, to avoid late fee if you attend the conference; membership fee is due with this registration form unless you have already paid) Late Fee: $_____ ($15 on-site or received after September 15, 2008; this fee is waived for residents of countries other than the USA or Canada) Total enclosed: $_____ Payment must be drawn on US bank or International Money Order and made payable to Midwest Popular Culture Association. Badge and receipt will be available for pickup at the conference. All conference participants must be members of MPCA/MACA and must pay the registration fee. Mailing address Send this form and payment (payable to MPCA) to Gary Burns Department of Communication Northern Illinois University 1425 W. Lincoln Hwy DeKalb IL 60115 Thank you!