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MADE 2006 REGISTRATION FORM
**** PLEASE TYPE OR PRINT NEATLY ****

Name: ______________________________________________________________________

Institution: ______________________________  Position/Title: __________________________

Office Address: _______________________________________________________________

Office Phone: (________)_________________ Office Fax: (________)____________________

Office Email: _________________________________________________________________

Home Address: _______________________________________________________________

Home Phone: (_________)________________ Home Fax: (_________)___________________

Home Email: _________________________________________________________________
If applicable, check one or both of the following:
_____ I am a new member of MADE.   
_____ I am attending the MADE conference for the first time.
As a paid member of MADE, you will receive the MADE newsletter.  Check all that apply but please allow only one mailing of hard copy, either office or home.  If you want to save MADE some money, don’t check a hard copy option at all; just check the email option(s). 
I want to receive all MADE correspondence including newsletter at my (via):
___ Office (hard copy)   ___ Office (email)   ___ Home (hard copy)   ___ Home (email)
If you are interested in a MADE t-shirt, please go to the T-Shirt Order Form.

Check must be enclosed for pre-registration.  Pre-registration must be received by Treasurer no later than October 6, 2006.  There will be no refund after deadline.  You must register on-site after deadline.  If your school is paying for your registration, it is your responsibility to make sure the school sends payment by the indicated deadline!