The United Nations at 60 Years

A Forum on the Future of the United Nations in the 21st Century

Registration Form

Name:___________________________________________________________________

Address:_________________________________________________________________

              _________________________________________________________________

Phone Number:___________________________________________________________

Email Address:___________________________________________________________

* Conference Fees (please check one):

_____ Student ($10.00) - paid on or prior to the pre-registration deadline (extended to October 14, 2005).

_____ Student ($15.00) - paid after the pre-registration deadline.

_____ Non-Student ($20.00) - paid on or prior to the pre-registration deadline.

_____ Non-Student ($25.00) - paid after the pre-registration deadline.

_____ Breakfast only ($3.00 students; $5.00 non-students)

_____ Luncheon only ($10.00 students; $15.00 non-students)

* Conference fees cover attendance at all sessions of the conference, including breakfast and luncheon.

Please make checks payable to "UCA Department of Political Science/AMUN".  Send registration forms and checks to Dr. Mark Mullenbach, 217 Irby Hall, UCA, Conway, Arkansas 72035.