Year 2001 Annual Conference Registration Form

DET/CHE 2002 ANNUAL CONFERENCE REGISTRATION FORM

December 2 - 5, 2002 ~ DoubleTree Hotel ~ San Jose, California
Hosted by: California State University, Stanislaus

Name: Title:

Institution/Organization:

Address (line 1):

Address (line 2):

City, State Zip Code

Daytime Telephone (w/ Area Code): FAX (w/ Area Code):

[  ] Yes, I am a DET/CHE Member ~ [  ] No, I am not a Member E-mail:

Conference Registration Fee (includes all meeting materials, breaks and designated meals)

___$275.00 full conference - member (2002-2003) ($300 after November 20, 2002)

_$325.00 full conference - non-member ($350 after November 20, 2002)

_$165.00 full conference - spouse/partner Name: _____________

_$  35.00 dinner banquet only for spouse/partner

_$400.00 full conference--walk-ins (Not Recommended)

_$75 membership dues for 2002-2003   (Not applicable to those paying the $325 registration fee)

_____Total Fees Due (Dues must be current for 2002-2003 in order to register as a member.)

Payment method: (payment to DET/CHE must accompany registration form)

[ ] check enclosed [ ] purchase order enclosed

Payment must be received before registration is considered complete. Dues must be current for 2002-2003 in order to register as a member.
Credit card payment cannot be accepted by DET/CHE.
To assist conference planning, please register as soon as possible.
Walk-in Registration is not recommended.
Cancellation Policy: If a registration is canceled by the registrant, a $55.00 service fee will be deducted from any payment. Registrants who do not attend or who cancel after the beginning of the conference are liable for the entire registration fee. Refund requests must be made in writing to the DET/CHE Treasurer, Susan Corum.

Special needs/assistance:

Special meal requirements:

Is this your first DET/CHE conference? [ ] Yes / [ ] No:

For further information about:
* Registration or about DET/CHE: (805) 893-8812; Bob Romanelli, DET/CHE Executive Office, UC Santa Barbara
* Program: (209) 667-3347; Brian Duggan, Program Chair, California State University Stanislaus
* Local sites: (408) 554-4915; Nancy Cutler, Santa Clara University; and (408) 924-2856; Chris Laxton, San Jose State University
* Sponsorship: (209) 667=3347; Brian Duggan, Program Chair, California State University Stanislaus
* DoubleTree Hotel Room Reservations: PLEASE CALL (408) 453-4000 DIRECTLY to get DET/CHE group rate of $139.
* Hotel Room Reservation Deadline: November 11, 2002. Conference Registration Deadline: November 20, 2002.

Make your check payable to "DET/CHE" and mail this completed form & payment to:
Bob Romanelli
Instructional Resources
University of California Santa Barbara
Santa Barbara CA 93106-3200
(805) 893-8812 FAX (805) 893-5895. romanelli@id.ucsb.edu Main Conference Page

_______$275.00 full conference - member (2002-2003)	($300 after November 20, 2002)
_______$325.00 full conference - non-member	($350 after November 20, 2002)
_______$165.00 full conference - spouse/partner	Name: _____________________
_______$ 35.00 dinner banquet only for spouse/partner
_______$400.00 full conference--walk-ins (Not Recommended)
_______$75 membership dues for 2002-2003 (Not applicable to those paying the $325 registration fee)
_______Total Fees Due (Dues must be current for 2002-2003 in order to register as a member.)

Name:	Title:
Institution/Organization:
Address (line 1):
Address (line 2):
City, State	Zip Code
Daytime Telephone (w/ Area Code):	FAX (w/ Area Code):
[ ] Yes, I am a DET/CHE Member ~ [ ] No, I am not a Member	E-mail: