MLA Midwest Chapter 2023 Annual Meeting Registration

MLA Midwest Chapter Meeting Registration

82nd Annual Meeting, Lexington, KY, November 2-4, 2023
Full Name*

First NameLast Name
Name to appear on tag, please include preferred pronoun/s
E-mail*
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Institutional Affiliation (if applicable)
Job Title/Role
YesNo
Dietary requirements (vegan, vegetarian, allergies, gluten sensitivity, etc.)
King Library Press ($5, 2 p.m., limited to 12 participants)Keeneland Racetrack Library ($5, 2 p.m., limited to 12 participants)Bluegrass Distillers ($20, 3 p.m., limited to 12 participants)
Regular - $85Student or Retiree - $50Single day (all registrants) - $50Late regular - $100Late single day - $65Virtual - $20
Contribution to Phyllis J. Schoonover Scholarship for Student Members - please enter amount
Contribution to Leslie Troutman Scholarship for staff and paraprofessionals - please enter amount
Unrestricted contributions - please enter amount
Pay by check - print out form and mail to address belowPay via PayPal - a PayPal invoice will be delivered via email
Please make checks out to MLA Midwest Chapter Assoc. and mail to:

Anne Shelley
Parks Library
Iowa State University
701 Morrill Rd.
Ames, IA 50011-2102
If paying by check, please print the form BEFORE submitting.
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MLA Midwest Chapter Meeting Registration