Registration Form

 
Name:
School:
Title / Position:
Mailing Address:
Mailing Address 2:
City:
State:
Zip Code:
E-Mail:
   
Check Payable to "Messiah College"
 
Credit Card:
 Visa American Express Discover Mastercard
Credit Card Number:
Expiration Date:
CID:
Name on Card:
Billing Address for Card( if different from above)




Shuttle Service:
Please check here if you need shuttle service between the conference hotels and campus.
  Please check here if you will have a car at the conference
Dietary Needs:
Do you have any special dietary needs?

Optional Trip to Gettysburg Battlefield Visitors' Center and Dobbin House Restaurant

Conferees who will not depart this area until Wednesday are invited to join colleagues for a tour of the Gettysburg Battlefield Visitors' Center Tuesday afternoon and evening, followed by dinner at a wonderful restaurant in Gettysburg,the Dobbin House. We can accommodate a total of twenty people for this excursion, so if you're interested, reserve your spot now checking the box below and adding an additional $10 to the registration fee. Further, each person will pay for his or her own meal, and you should expect that the cost of your meal at the Dobbin House will likely be in the neighborhood of $50 per person.
  I would like to participate in the excursion to the Gettysburg Visitors' Center and dinner at the Dobbin House Restaurant.