2010 Conference Registration

Your Registration Information Please complete the information below, then click "Send information to JAWS". You will then be able to pay for the conference using Paypal.
Full Name:
Job Title:
Employer:
Address:
City, State, ZIP:
Email:
Work Phone:
Home Phone:

Please include a brief biography:

YES!I'd like to be assigned a mentor for career consultation.
YES! I'd love to be a mentor for another JAWS member!
YES! I'll arrive in time for dinner Friday!
YES! I'll be there for dinner Sunday!
YES! I'll have books for the Saturday night book party!
Veggie meals Please make my food vegetarian.
Special pre-camp session: Edward and Cynthia Miller will be available throughout the symposium weekend for one-on-one sessions. They'll also be around on Friday afternoon from 1 - 4 p.m. There is no extra charge to participate; we just need to know if you are interested. You will sign-up for a time when you get to Camp. Yes Yes, I want a time with the Millers on Saturday or Sunday Yes I want a time with the Millers on Friday, Oct 22. (Friday spaces are very limited and will be scheduled on a first-come basis.)