Register for the DSA Convention 2007

I want to register for the convention
First Name
Last Name
Address
City/State/Zip
Email Address
Phone
Cell Phone


DSA local (if representing a local)
I plan on arriving in Atlanta on

I am looking for someone to share a hotel room with.
I am interested in serving on a convention committee.

Payment:
Special pre-registration rates:

2007 Delegate Registration Fee $175
2007 Alternate Delegate Registration Fee $175
2007 Observer Fee $175

These rates include convention materials, three meals and coffee breaks and snacks during the Convention. Delegates and Alternate Delegates must pay the full fee regardless of when they arrive or leave the convention.

Payment after October 30th or at the convention site is an additional $25.

Daily rates for observers from the Atlanta area have not been set yet.
Payment method:
(the special pre-registration rates are only available if paid on-line or post-marked by October 30th)

Pay at the door (not good for pre-registration discount)
Pay by mail
Pay on-line with credit card (VISA or Mastercard only)

Once you have completed this form, please click the “Send Form” button below.
**IF YOU ARE PAYING ON-LINE WITH A CREDIT CARD, YOU MUST CLICK ON A LINK PROVIDED IN THE PAGE THAT FOLLOWS ONCE YOU HAVE SUBMITTED THIS FORM. You will be sent to a separate on-line payment form.