Conference Registration Form

NATIONAL ASSOCIATION FOR KINESIOLOGY AND PHYSICAL EDUCATION IN HIGHER EDUCATION

Academic Preparation for the 21^st Century Student

Hilton El Conquistador Resort, Tucson, AZ

January 5-8, 2005

First Name (name for badge) Last Name

Institution Street address

City State Zip Code

Phone Number E-mail address

Registration Fees ^1,2	Before 12/01/04	After 12/1/04 or On Site	Amount Paid Enter amount for each below
NAKPEHE Member	$175	$200
Non-member	$200	$225
Graduate Student Member	$100	$120
Emeritus/Retiree	$136	$156
Guest for Homans Luncheon	$32	$32
Guest for Sargent Breakfast	$32	$32
Guest for Delphine Hanna Reception	$25	$25
Total (add conf. fee and meals)

^{1 Registration fees
include cost of all mailings, programs, abstracts, publication, reception
following Hanna Lecture, Homans luncheon, Sargent Breakfast,}^{refreshment
breaks, and audiovisual equipment.}

²If uncertain of membership status, contact Jackie Lund at jllund@att.net DO NOT send membership fees with this form. Send membership fees directly to Jackie Lund.

Complete this form, print out and mail completed registration with a check (made payable to NAKPEHE) for the total amount to:

Bill Forbes, Wellness Center, Towson University, 8000 York Rd, Towson, MD 21252

Note: NAKPEHE is unable to accept credit cards. Check or cash only accepted on-site.