SWC Meeting Registration

When: November 14, 2012

Where: Baltimore Marriott Inner Harbor at Camden Yards, 110 South Eutaw Street, Baltimore, MD 2120

Please make hotel reservations before Tuesday, October 30, 2012 by calling Baltimore Marriott Inner Harbor at Camden Yards at (800) 228-9290 or (410) 962-0202 and ask for the 'Penn State University Stripper Well Meeting' special rate to get $179 single room rate plus applicable taxes.

Registration Fee:
Full Member (no fee for up to 4 people)
All Others ($375/person)

Personal Details
First Name: *
Last Name: *
Affiliation: *
Address: *
City: *
State: *
Zip Code: *
Country: *
Phone Number: *
Fax Number:
Email: *
* Indicates a required field

Registration Details
Attendee Name #1: *
Attendee Name #2:
Attendee Name #3:
Attendee Name #4:
Meals: *	Breakfast November 14 Lunch November 14 No Meal Required
Membership Type: *	Full Member (no fee for up to 4 people) All Others ($375/person)
* Indicates a required field



Please submit your check to: *Checks only will be taken at meeting registration desk on day of meeting.
Questions: Telephone: (814) 441-1100 Fax: (814) 863-7432 swc@ems.psu.edu	Submit to: Attn: SWC Meeting Registration Penn State University C-211 CUL University Park, PA 16802-2323

First Name: *
Last Name: *
Affiliation: *
Address: *
City: *
State: *
Zip Code: *
Country: *
Phone Number: *
Fax Number:
Email: *
Attendee Name #1: *
Attendee Name #2:
Attendee Name #3:
Attendee Name #4:
Meals: *
Membership Type: *

SWC Meeting Registration

Personal Details

Registration Details