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REGISTRATION FORM

Mail to: Conference on John Milton, c/o Kevin Donovan, MTSU Box 401,

Murfreesboro, TN 37132

Name  _________________________________________________  

Position  __________________________________________

Institution  _____________________________________________________________

Mailing Address (Street) ___________________________________________________

City, State, Zip __________________________________________________________

E-mail ___________________________________________________

_____I need AV equipment for my presentation.  (Please specify.)

Fee:  $______ at $120 per person for _______ registrants.

The registration fee may be paid by check, money order, or bank draft.

Please put ­­­____ names on the list for dinner at Cortner Mill.

The cost of dinner is $30 per person.

(Feel free to wait until the conference to pay for the dinner at Cortner Mill.)

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