Registration 2018 Winter Virtual Conference
January 12 - February 16, 2018

Questions?
Contact Mona Tipton, monatipton@ku.edu, 785-864-0626 with questions about the Conference
Contact Jeannie Heil, orderkucrl@ku.edu, 785-864-0617 with payment/billing questions

First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Mailing Address 1
(Especially important if you select the DVD option)
Your answer
Mailing Address 2
Your answer
City, STATE
Your answer
Zip Code
Your answer
Choose all that apply:
Which Webinar do you plan to attend?
Payment includes (check all that apply): *
Required
I will be paying by: *
If you are paying online and the credit card is from an entity other than your personal card, who will the payment come from (so we can match you to the payment) .
Your answer
Thank you!
Don't forget to complete STEP 2 of the registration process, submitting the registration fee.

Refund Policy: If you cannot attend this conference, you must notify KU-CRL by January 4th to receive a refund of your registration fee minus a cancellation fee of $25 We will be unable to issue any refunds for cancellations received after January 16.

Notes
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms