2018 Conference

(Note: An * indicates a required field.)

You will receive a confirmation of your registration within two weeks after you submit this form via e-mail. It will serve as your receipt. Receipts will not be mailed or faxed. If you do not have an e-mail address, the receipt will be provided at the conference.

* FIRST NAME:

* LAST NAME:

BIRTHDATE:

INSTITUTION:

ADDRESS (where your credit card statement is mailed):
* No. & Street:

* City:

Please enter "none" if no state/province.
*State/Province:

*ZIP/Postal Code:     Country:

TELEPHONES (U.S. residents, please include area code.  International residents, please include country and city codes.):
Home:

Work:

*E-MAIL:
  Please enter your WPSA membership email if you are currently a member or were a member previously,
  otherwise a new membership account will be created with the email you provided.

* Rank:


*CONFERENCE REGISTRATION FOR (select one):

$155 - WPSA member
$225 - NON-MEMBER
$75 - Student/Retiree

WPSA Membership rates: (If you are currently a member or have been a member in the past this will automatically renew your membership under the same email you provided above. Other wise a new account will be created for you with the provided email.)

There is a surcharge of $1.00 for those using a credit card (only Visa or Mastercard are accepted); a surcharge of $2.50 for postage for Canada and Mexico, and $4.00 for postage for all other foreign countries.

**You may pay for your dues now and register for the convention as a member at the same time, but you must indicate that you are paying for your membership as well. All dues paying members of the WPSA receive a subscription to the Political Research Quarterly.

Check here if you want to receive a hard copy subscription to the journal. All members have online access to the journal; a hard copy subscription is not available to members paying reduced membership fees (students/retirees).


If you would like to make a donation to the WPSA, please select the amount below. Please note this will all be charged onto one credit card. The WPSA is a 501(c)3 not-for-profit organization; as such, your contributions are fully tax-deductible, as permitted by law.

Donation Amount: $
Where would you like your donation to go towards?

Please note that registration fees are not refundable.


Do you have an account on one of the following information technology/social media tools?

No Yes

If yes, please provide the account name/address or URL where applicable
Facebook
Twitter    
Blog        

Do you anticipate the need for child care, and would you like further information about it?

No Yes

Are you a participant in the upcoming meetings?

No Yes

In compliance with the Americans with Disabilities Act required under Title III, do you require special accommodation (i.e. auxiliary aids and services, accessible sleeping room, etc.)?

No Yes

And explain the need here:

I authorize the WPSA to send notification of membership meetings via e-mail.

No Yes

If you are experiencing problems submitting your registration or have questions about the WPSA conference, please send a message to favilaej@csus.edu.