KYMATYC 2022 Registration Form

KYMATYC 2022 Registration Form

Friday - Saturday, Feb. 25-26, 2022 Boone Tavern, Berea, KY
Full Name

First Name Last Name
E-mail
Address

Street Address

Street Address Line 2

City State

Postal / Zip Code Country
Phone Number

Area Code Phone Number
College/University
Conference Fees

	Before Feb. 7th	After Feb. 7th
Conference Registration	$75.00	$85.00
Presenter Discount ($40.00 per sesssion - can be split among multiple presenters)
Adjunct Registration	$10.00*	$10.00*
Vendor Registration	$300.00	$350.00

*Adjunct registration will be refunded at check-in.

Conference Registration Total
Vendor Registration Total
Room Reservations
Room Reservations:

I need a room for Thursday night only. I need a room for Friday night only. I need a room for both Thursday and Friday night.
I will be sharing a room with:
I request the following special room accommodations(ADA, Hearing Impaired, other - subject to availabilty)
Scholar Full (1 full bed) (per person, all accommodations are non-smoking):

Single, $94.00 Double, $47.00
Queen (1 queen bed) (per person, all accommodations are non-smoking):

Single, $106.00 Double, $53.00
King (1 king bed) (per person, all accommodations are non-smoking):

Single, $106.00 Double, $53.00
Double Double (2 full beds) (per person, all accommodations are non-smoking):

Single, $106.00 Double, $53.00
Total - room for Thursday Night
Total - room for Friday night
Room reservations received by February 7 are confirmed. Other room types/rates may be available. After Feb. 7, rooms are subject to availability (Please e-mail jeff.herrin@kctcs.edu for any questions).
Meal Reservations (drinks, tax, and gratuity included in this amount)*
Number of Adult Meals - Friday Dinner Buffet each $30.00
Number of Adult Meals - Saturday Breakfast Buffet each $16.00
Total - All Meals $
Grand Total - Enter total of entire form here.
*Please email jeff.herrin@kctcs.edu with any dietary restrictions.
If you wish to pay by credit card, you may do so through the secure PayPal link on the KYMATYC website conference page.

Please send the grand total by February 7, 2022 to KYMATYC Registration, c/o Jeff Herrin, President Elect, 3205 Buckhorn Drive, Lexington, KY 40515. Any exceptions need to be approved via e-mail jeff.herrin@kctcs.edu.

Please keep KYMATYC costs low. Any changes in the registration form or cancellations need to be reported in a timely manner. If you have questions, please e-mail jeff.herrin@kctcs.edu.
KYMATYC is committed to serving all conference attendees with disabilities and adheres to the guidelines set forth in the Americans with Disabilities Act. Attendees with disabilities requiring special accommodations should contact KYMATYC before February 7, 2022.
Please print a copy of this form for your personal records, especially if you may need a copy for reimbursement purposes at your college or university.
Should be Empty:

KYMATYC 2022 Registration Form

Conference Fees

Room Reservations

Meal Reservations (drinks, tax, and gratuity included in this amount)*