Registration Form Society for Ethics Across the Curriculum c/o St. Louis Community College (Meramec), 11333 Big Bend Rd, St. Louis, MO 63122 • PH (314) 984-7934 • Fax (314) 984-7254 th 13 International Conference, November 3-5, 2011 – Moonrise Hotel, St. Louis MO Name: ____________________________________________________________________________ Address: ____________________________________________________________________________ Phone _________________________ Email ____________________________________________ Institutional Affiliation, if applicable ____________________________________________________________ □ I am willing to chair a session. Note that membership in the Society includes a subscription to Teaching Ethics. Membership Dues Current Year (2011) Dues ($30 individual or $50 institutional) $ ________ Membership Dues Next Year (2012) Dues ($30 individual or $50 institutional) $ ________ Registration Fee ($70 for current SEAC members; $100 for non-members) $ ________ Banquet, Friday, Nov 4 $35 per person □ Vegetarian Reserve ____ places $ ________ TOTAL $ ________ Please make check payable to: Society for Ethics Across the Curriculum Mail to: Donna Werner Secretary-Treasurer, SEAC Humanities Department (HE 101) St. Louis Community College (Meramec) 11333 Big Bend Rd St. Louis MO 63122-5720 OR you can pay online via credit card at LINK
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