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CONNECTICUT SONGWRITING AND PERFORMANCE CONFERENCE
REGISTRATION FORM
NOTE: Your personal information will NOT be shared
with any other organization.
(We need your e-mail address to send you Conference Updates )
First Name___________________________ Last Name
________________________
Home Address
__________________________________________________________
_____________________________________________________________________
Home Phone: ( ) _____________________ E-mail:
________________________
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REGISTRATION FEES
(for individual attendees who are Professional
Educators or members of CSA, RISA, BSW, IndieGrrl, Folk Alliance, or
Songsalive
Postmarked by: |
12/31 |
2/29 |
3/31 |
On site |
TOTAL |
|
$30 |
$35 |
$40 |
$45 |
$___________ |
Others:
Postmarked by: |
12/31 |
2/29 |
3/31 |
On site |
TOTAL |
|
$45 |
$45 |
$45 |
$50 |
$___________ |
Students (age 18 or under) or Students at Three Rivers ……………….$20
anytime .……$___________
Meals (includes both Lunch and Supper)………………………… .…$12…………….…..$
__________
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VENDOR/EXHIBITOR TABLE Registration
( INCLUDES 1 Conference Registration for all events, a web link, and
assistants to staff your table.
Postmarked by: |
12/31 |
2/29 |
3/31 |
|
TOTAL |
|
$65 |
$75 |
$85 |
|
$___________ |
Number of people staffing table x $12 each for meals)…………………………..
$___________
TOTAL : Enclosed is my check/money order for $ _________
OR Charge my ____VISA ____Mastercard
Credit Card #____________________________________ Exp Date
_____/_____
Registration includes access to all events, including the evening
concert. Concert proceeds benefit social service agencies in Connecticut
through LUNCH.
MAIL Registration Form and Check payable to :
CSA Attn: Bill Pere, PO Box 511 , Mystic CT 06355
(Professional educators seeking CEU's -call 860-572-9285 for CEU
forms IN ADVANCE)
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Optional Information:
Your Website URL: ______________________________________________
Some background about yourself:
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