Registration Form                                                                                    5091njs

5th Triennial Conference of The Kenneth Burke Society

New Orleans, Louisiana, May 23-26, 2002

Name_______________________________________________________________________

Affiliation___________________________________________________________________

Mailing Address______________________________________________________________

City ____________________________ State _____________________ Zip _____________

Phone __________________ Fax ___________________ Email _______________________

Regular Registration: Registration fees for nonmembers includes a one-year membership in the Kenneth Burke Society. Please check the appropriate space according to your membership and/or student status and according to the timing of your registration, then enter the total in the space provided.

By April 15:         ______ $120 -- KBS Member               ______ $140 -- KBS Nonmember

After April 15:      ______ $130 -- KBS Member               ______ $150 -- KBS Nonmember

Student Registration (KBS Members and Nonmembers; must be a full-time student)

______ $75 -- (before April 15)             ______ $85 -- (after April 15)

TOTAL ENCLOSED:   $______

Payment Method

Send check or money order payable to Purdue University or charge to:

(check one):   ___ MasterCard    ___ VISA      ___ Discover

Account Number __________________________________________

Expiration Date ___________________________________________

Authorized Signature _______________________________________

* Registration fee includes Thursday evening buffet and reception, Saturday evening banquet, Friday, Saturday and Sunday continental breakfasts and Saturday lunch. Meals (check one): ___vegetarian ___non-vegetarian   

Hotel Accommodations

Rooms have been reserved at the Holiday Inn-French Quarter (Phone: 800.747.3279; Single: $129 + Tax. Double: $129 + Tax) and  the Chateau LeMoyne (800.747.3279; Single: $149 + Tax Double: $149 + Tax). Contact the hotels directly to make reservations. Be sure to mention the “Kenneth Burke Society Group” to receive the group rate. For planning purposes, please let us know where you intend to stay:

____ Holiday Inn-French Quarter   _____ Chateau LeMoyne      _____ Other Arrangements

For information on registration:  

Nona Schaler, Conference Division 
Phone (765) 494-2756 or (800) 359-2968
Fax:  (765) 494-0567 

For information about the program contact:

David Blakesley, Purdue University
Phone: (765) 494-3772
Fax: (765) 494-3780
Email: blakesle@purdue.edu

Make checks payable to Purdue University, and mail to:

Business Office, Conference Division
Purdue University
1586 Stewart Center, Room 110
West Lafayette, IN  47907-1586
Fax (765) 494-0567

Purdue University is an equal access/equal opportunity university.