Registration Form
Joint Conference of
The American Society for Engineering Education - St. Lawrence Section
and
New York Cyber Security and Engineering Technology Association


2018 Conference Registration
April 20-21, 2018       Cornell University       Ithaca, New York







E-mail Address:
Password:

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AFFILIATION

    ASEE             NYS ETA             Both ASEE & NYS ETA             Neither             ELI        

       


CONTACT INFORMATION

Saluation:
    Dr.           Professor           Mr.           Mrs.           Ms.           Miss      

Name:
    First:     Middle Initial:     Last:

Name to Appear on Badge:

Title:

School/Organization/Company:

Address:
    Address Line #1:
    Address Line #2:
    City:     State/Province:     ZIP/Postal Code:
    Phone Number (Day):

When will you be arriving?     Friday, April 20     Saturday, April 21    
Will you be attending the banquet?     Yes     No
Would you be interested in judging posters?     Yes     No    
Will a guest be attending the banquet?     Yes     No
    Name of Guest (if applicable):    

Registration Type: Early Registration
(on or before 4/9/18)
Regular Registration
Professional (Friday & Saturday) $135 $165
Professional (Saturday) $105 $130
Retiree $75 $100
Student (with Friday banquet) $65 $80
Student (without Friday banquet) $35 $40
Banquet Guest $65 $90
Exhibitor
    Platinum ($1,000 and up)
    Gold ($500 and up)
    Silver ($250 and up)

 
Student Volunteer
      Registration required, meals included.
      Limited availability.
      Confirm with conference organizers (CSE-ASEE@buffalo.edu)
No charge No charge
Lunch Preferences
    Chicken
    Salmon
    Vegan
   


       
        Method of Payment:
    Credit Card (ASEE Members Only)
    Check
    Check sent by my instituion with my name indicated.

Please make check payable to:
ASEE (Memo: St. Lawrence Section with Registrant's Name)

Send check to:
Jill Powell, Treasurer, ASEE St. Lawrence Section
103A Carpenter Hall, Cornell University
Ithaca, NY 14853