UMACRAO - Class of 2007: Accelerate Your Learning

First Name * MI Last Name *

Institution * Job Title *

Street *

City * State * Zip *

Phone *

Email * Confirm Email *

Are you a First Year Student (First Time Attendee): Yes

(or) When did you join UMACRAO?

(or) Which year or location was your first UMACRAO conference?

Are you in need of special physical accommodations? Yes

If so, please describe:

Are you in need of special dietary accommodations? Yes

If so, please describe:

Individual Guest Meals:

Thursday Breakfast ($10) Friday Breakfast ($10)

Thursday Lunch ($10) Friday Lunch ($10)

Thursday Banquet ($20)

I am paying for:
Full Tuition $115 Partial Tuition $70 (does not include Banquet)

If you register after October 17th, there is an additional $10 late or on-site registration fee.

Once you submit this form, you will receive a confirmation email which you can print as an invoice and receipt.

You will need to mail your payment to:
UMACRAO
Jody Ragan
Concordia University
275 Syndicate St N
St. Paul, MN 55104

If you have any questions, about your total or fields on this form, please contact Jody Ragan

Admission Application for UMACRAO 2007