INDIANA ASSOCIATION OF HISTORIANS
2012 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, 2012. After that date, please register at the conference.

Name ___________________________________________________________

Address __________________________________________________________

City _____________________________ State _____________ Zip ________

Institutional Affiliation ________________________________________________

Daytime Telephone __________________________________

Email _____________________________________________

Registration covers continental breakfast and luncheon.

Registration fee for the IAH annual meeting is $40 __________

Registration fee for the IAH annual meeting (for IAH members) is $35 __________

Student registration fee is $20. __________

Send your check made out to "Hanover College" to:

Dr. Matthew N. Vosmeier
IAH 2012 Annual Meeting
Hanover College
P.O. Box 890
Hanover, Indiana 47243

No special hotel arrangements have been made for the annual meeting. Information about accommodations in the Hanover and Madison area can be found through a link at the annual meeting web site: http://history.hanover.edu/iah2012.html

Cancellation Policy: Any refunds must be requested in writing. No refunds will be issued after February 10, 2012.