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Registration Form
JSA Professional Development Workshop
Living With Godzilla: Challenge, Tribulation, Resilience, and Transformation in Heisei Japan
April 12-14, 2018
Hendrix College, Conway, Arkansas
Registration Deadline Extended
Participant Information
*
Indicates required field
1. Name
*
First
Last
2. Institution
*
3. Academic position
*
4. Academic discipline
*
5. Professional (institutional) address
*
Line 1
Line 2
City
State
Zip Code
Country
6. Work phone
*
7. Cell phone
*
8. Preferred e-mail (shared with workshop participants)
*
Logistics
Registration includes two nights lodging (Thursday and Friday) at the Hilton Garden Inn, Conway, Arkansas, with breakfast. Included also are two light lunches, reception on Thursday night, dinner on Friday night, and JSA membership for 2018.
$500 (single room) or $475, if already JSA member.
$385 pp (for those planning to share a twin room) or $360, if JSA member.
Free pick-up at airport may be possible at 2:30, 4:30 and 6:30 Wednesday April 11.
Free transportation between hotel and meeting rooms at Hendrix College.
For local participants (no hotel): $200 or $175, if already JSA member. Registration includes two lunches and the Thursday reception. Friday’s dinner is optional for an additional $20.
9. Accommodation (please select all that apply)
*
I would prefer double occupancy (registration fee: $385 pp / $360 pp, if JSA member)
I would prefer single occupancy (registration fee: $500 / $475, if JSA member)
I am local and do not require accommodation (registration fee: $200 / $175, if JSA member)
Friday dinner for a local participant, $20
10. Payment (please choose one)
*
I will make the registration payment myself online
My institution will make the registration payment online
I will pay the registration fee by check
My institution will pay the registration fee by check
11. Dietary requirements
*
No dietary requirements
I am vegetarian
I am allergic / intolerant to
Please specify
*
12. How do you plan to travel to Conway, AR?
*
I plan to fly into Little Rock Airport and would appreciate transportation to the workshop hotel
I plan to drive to Conway, AR
I am local and do not require transportation
13. How did you find out about this Workshop?
*
14. Any comments?
*
Please note
: To benefit fully from this professional development workshop, please make suitable travel arrangements so that you arrive no later than 8:30 AM on April 12, 2018 and leave no earlier than 1:30 PM on April 14.
Registration payment by check
If payment by check is your preferred option, please complete this registration form, print it out and mail it to Prof. Stacia Bensyl together with your check to the following address:
Stacia Bensyl
Professor of English and JSA Treasurer
Department of English, Eder Hall 222-I
Missouri Western State University
St Joseph, MO 64507
Alternatively, complete the registration form, save it as a Word Document and e-mail it to Prof. Bensyl at
[email protected]
. Please indicate in your e-mail the date on which you have mailed your registration fee.
A receipt of payment and confirmation of registration will be issued once we have received both your payment and registration.
Submitting the registration form will automatically redirect you to the payment portal. We'd appreciate your patience with the double verification that you are not a robot.
Submit registration form