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PRESENTER_PreRegistration_FormsABC2012

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					Form A
                        “Women and Labor: At Home, At Work, Around the Globe”
                                           PRESENTER PRE-REGISTRATION


                                                    1 Day              2 Days             # Registering/price
Conference Presenter                                $75.00             $105.00            _____@$_____                = $__________
Conference Presenter (Student)                      $50.00             $75.00             _____@$_____                = $__________
Conference Presenter (SCSU Faculty)                 $50.00             $75.00             _____@$_____                = $__________

Conference registration fees, which have stayed flat since 2007, include all conference materials and events, including sessions, keynotes,
art reception, the Women’s & Girls’ Fair, and all meals and beverage breaks. This conference is self-supporting; registration fees are
calculated based on the actual costs of organizing the conference.

Shuttle Service                                                                           _____ @ $ 25.00             = $__________
(to and from campus and designated hotels- $25 per person

Scholarship Donation                                                                                                  $____________
(to subsidize conference registrations for individuals with limited means)


Total Amount Enclosed                                                                                                 $____________

Please make checks payable to SCSU

Credit Card Registration
ALL credit card payments MUST include CVC number or they will not be processed

Type of Card           ‫ ڤ‬Master Card                ‫ ڤ‬Visa

Credit Card #          _______________________________________________________
Expiration Date        __________________________ CVC # ___________________
                                                                       (Three digits on back of card)
Print Name             _______________________________________________________
Signature              _______________________________________________________

Please postmark all materials by March 9, 2012 to ensure pre-registration rates. An additional $15.00 will be applied after March
9, 2012. The Women’s Studies Program regrets that it cannot refund conference registration payments.
Form B
                  “Women and Labor: At Home, At Work, Around the Globe”
                                CONFERENCE PRE-REGISTRATION
Please provide all of the information requested below. Please duplicate for multiple registrations.

Name: _________________________________________________________________

Affiliation (for name badge): ________________________________________________

Mailing Address: _________________________________________________________

________________________________________________________________________

Phone (daytime): __________________                       Email: __________________________

         (evening): __________________                      Fax: ___________________________

 Presenter                 Non-presenter

May we include you on our network list?                   Yes                    No
(This list will be restricted to SCSU use only)

I will attend (Please mark all that apply):

 Friday Dinner                             Saturday Lunch                      Saturday Reception

Which hotel will you be staying at? (Conference presenter rates will be published at
www.southernct.edu/womenstudies by Tuesday, January 31, 2012)

 noiralC          New Haven Hotel           Hotel Duncan              La Quinta           Courtyard Marriott

Please indicate special needs or food restrictions below and we will try to meet them:
(Food served at the conference will include dairy, but not meat or fish.)

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

All spaces used for the conference are wheelchair accessible.

Please mail completed registration forms to:                            Fax registration forms to:
Southern Connecticut State University                                   203-392-6723
Women’s Studies Program
501 Crescent Street                                                     Email registration forms to:
New Haven, CT 06515                                                     womenstudies@southernct.edu
Attn: Conference Committee

Please be sure to fill out forms A and B and mail, fax, or email materials by March 9, 2012 to ensure pre-registration rates.
Form C
                  “Women and Labor: At Home, At Work, Around the Globe”

                           INFORMATION ABOUT YOUR PRESENTATION


Please duplicate as needed for multiple presentations/panels. Please ensure accuracy, as all information will
be used in the conference program.

Name of Presenter: ______________________________________________

Title of your presentation (As it should appear in the conference program):

________________________________________________________________________

Audio/Visual Needs (If your presentation is on computer disk, please specify if you need PC or Macintosh
equipment):

_______________________________________________________________________
________________________________________________________________________




Presentation Abstract:




Note: Please limit the length of the abstract to no longer than 150 words. Write a short description of your
presentation to be included in the conference program. The following is an example of a presentation
description to use as a reference from a previous conference.

“What has been the lived experience of a Black Latina immigrant family in terms of race, gender, and class? As
educators, we are interested in exploring this question through the lens of a short video clip and interactive workshop.
In this present wave of English Only, anti-immigrant, anti-gay, anti-women legislation, we feel that now, more than
ever, we need to hear the voices of ‘outsiders’ and ‘insiders’ in a joint effort to create socio, cultural, and political
change.”

				
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