RESEARCH SOCIETY FOR VICTORIAN PERIODICALS CONFERENCE

              V i c t o r i a n   G e o g r a p h i e s

                       SEPTEMBER 15 - 16, 2006
          THE GRADUATE CENTER, CITY UNIVERSITY OF NEW YORK

                  R E G I S T R A T I O N   F O R M

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PLEASE PRINT OUT THIS FORM AND MAIL IT WITH A CHECK IN U.S. FUNDS TO:

Anne Humpherys
Ph.D. Program in English
The Graduate Center CUNY
365 Fifth Avenue
New York NY 10016

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NAME:               ______________________________________________
                    (as you want it on your badge)

ADDRESS:            ______________________________________________

CITY/STATE/ZIP:     ______________________________________________

COUNTRY:            ______________________________________________

EMAIL ADDRESS:      ______________________________________________

REGISTRATION FEE:   ____ $140.00  _____  $85.00 (GRADUATE STUDENT RATE)

PAYMENT (CIRCLE):   CHECK / TRAVELER'S CHECK / MONEY ORDER

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*  PLEASE MAKE CHECKS PAYABLE IN U.S. FUNDS TO "ANNE HUMPHERYS" WITH 
   "RSVP 2006 CONFERENCE" IN THE MEMO LINE.

*  ON-SITE REGISTRATION WILL BE BY CHECK (U.S. DOLLARS) ONLY. 

*  THE REGISTRATION FEE INCLUDES CONTINENTAL BREAKFASTS, BUSINESS 
   LUNCH, RECEPTIONS, AND COFFEE BREAKS. 

*  FOR ADDITIONAL INFORMATION ABOUT THE CONFERENCE PROGRAM AND HOTEL 
   OPTIONS, PLEASE VISIT http://www.rs4vp.org/2006conf.html.

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