INDIANA ASSOCIATION OF HISTORIANS
2006 ANNUAL MEETING
REGISTRATION FORM

Print this form and mail it with your payment to the address below.

Please submit a separate form for each registrant.

The deadline for pre-registration is February 10, 2006. After that date, please register at the conference.

Name ___________________________________________________________

Address __________________________________________________________

City _____________________________ State _____________ Zip ________

Institutional Affiliation ________________________________________________

Daytime Telephone __________________________________

Email _____________________________________________

Registration covers continental breakfast, coffee breaks, and luncheon.

Registration fee for the IAH conference is $40 __________

Registration fee for IAH members is $35 __________

Student registration fee is $20. __________

Total Due __________

Send your check made out to "Hanover College" with this form to:

Hanover College
P.O. Box 108
Hanover, Indiana 47243

No special hotel arrangements have been made for the conference. Information about accommodations in the Hanover and Madison area can be found through a link at the conference web site: http://history.hanover.edu/iah2006.html

NOTE: You will NOT receive any confirmation of your registration prior to the conference.

Cancellation Policy: Any refunds must be requested in writing. No refunds will be issued after February 10, 2006.