Registration Form for Keynote Banquet
Eighth Native American Symposium
with Heather Rae
November 6, 2009 7:00 PM

Please Print or Type:

Name:__________________________________________________________________________________


Address:_______________________________________________________________________________

E-mail address:________________________________________________________________________

Phone:_________________________________________________________________________________

Banquet Meal is $25.00 per person

Number of persons in party: ___________________________________________________________

Total Enclosed:________________________________________________________________________

Please enclose a check or money order made out to the Southeastern Foundation and mail this form with your payment by Wednesday, October 28, 2009 to:

Dr. Mark B. Spencer
Box 4121
Southeastern Oklahoma State University
Durant, OK 74701-0609


LATE BANQUET REGISTRATION CANNOT BE ACCEPTED


FOR FURTHER INFORMATION CONTACT:

Dr. Mark B. Spencer
Department of English, Humanities, and Languages
Southeastern Oklahoma State University
Durant, OK 74701-0609
(580) 745-2921
mspencer@se.edu

All symposium sessions are free and open to the public.

Please contact Dr. Mark B. Spencer at (580) 745-2921 or Southeastern Oklahoma State University at (580) 745-2394 to request assistance due to a disability. Accommodations cannot be guaranteed without adequate advance notice.