The American Society of Criminology
2017 Annual Meeting Registration Form – Philadelphia, PA - November 15-18, 2017
www.asc41.com
Please mail to American Society of Criminology, 1314 Kinnear Rd, Ste. 212, Columbus, OH 43212, or fax to (614) 292-6767.
Full Name for Badge:Affiliation for Badge:
City, State:
Country:
Phone: / E-mail:
ATTENDEE LIST: Do you authorize us to publish your name and affiliation to our public attendee list on the ASC website? Y N
PROGRAM OPTION: Please choose which version of the program you would like to reserve. If you have not used the smartphone app before, we urge you to choose the printed program to ensure enough books are ordered. If you choose “App Only,” there will not be a printed program for you. However, you may check with us at the end of the meeting regarding the availability, if any, of leftover printed programs.
____ Smartphone App Only / ____ Printed Program (includes Smartphone App access)
REGISTRATION FEES
All Meeting Attendees/Participants Are Required To Register
PAYMENT MUST ACCOMPANY REGISTRATION FORM TO BE OFFICIALLY REGISTERED.
(A receipt will be sent via email.)
Postmarked or faxed ON or AFTER October 1____ ASC Member: $200.00
____ Non-Member: $240.00
____ ASC Student Member: $60.00
____ Student Non-Member: $110.00
Optional Special Events (Schedule TBA)
Division of Corrections and Sentencing Annual Business / Awards Breakfast Meeting (225 person limit) / ____ All Tickets: $15.00
Division of International Criminology Awards Presentation and Luncheon (120 person limit) / ____ Students: $10.00
(First 50 students Free) / ____ Non Students: $20.00
Division on People of Color & Crime Symposium Luncheon and Awards (90 person limit) / ____ All Tickets: $35.00
Division on Women & Crime Social / ____ All Students: $5.00 / ____ Non-Students: $15.00
Ruth D. Peterson Fellowship for Racial & Ethnic Diversity Dance / ____ ASC Student Member: $5.00
____ Non ASC Member Student: $10.00 / ____ ASC Member: $10.00
____ Non ASC Member: $20.00
*If you are paying by check or money order, please make it out to American Society of Criminology. (U.S. FUNDS ONLY). A service charge will be assessed for all returned checks. *Accepted Credit Cards: Visa, MasterCard, American Express, Discover
Credit Card #: / Exp. Date: / CCV #:
Billing Street Address: / Billing Zip Code:
Name on Credit Card:
Email Address for credit card receipt (if different from above):
Refund Policy: Advance registration fees will be refunded for cancellations received up to September 30. No refunds will be made on cancellations received after this date.
Section to be filled out by ASC
Total ______/ Date ______/ Check/MO # ______/ Credit Card ______