SRFIDC 2020 Annual Conference & Membership Registration
Submit your registration information here.
Email address *
SRFIDC 2020 Annual Conference Fees
Individual = $175.00
Institutional: (includes 2 representatives) = $250.00
Each additional representative = $125.00 each

NOTE: Membership in the professional organization (Conference registration) does NOT include accommodations. Please be sure to make your own lodging reservations directly; see the hotel information on the Conference Information page of the SRFIDC web site.

Make membership dues/conference registration checks payable to SRFIDC. Be aware that dues and pre-paid conference registration are not refundable. After filling out this registration form please mail your payment to:

Irene Kokkala
Distance Education & Technology Integration
375 Library Technology Center
University of North Georgia
82 College Circle
Dahlonega, GA 30597
Tax Identification Number: TIN #51-0318435

NOTE: Before you press the "Submit" button, print a copy of this page and send with payment to the address above.
This registration is for
Amount enclosed: *
Enclose check with printed form including information.
Your name, if joining as an individual member
Name of Institution *
Name of Institutional Representative *
(enter "self" if individual member)
Name of Center or Faculty Support Unit
Number of attendees from your institution: *
Please indicate the number of people from your institution for which you are paying dues. These dues entitle your institution to participate in the SRFIDC Annual Sharing Conference.
Street *
City *
State *
ZIP postal code *
Phone number *
Website (optional)
Other Institutional Member 1
Other Institutional Member 2
Other Institutional Member 3
I have printed a copy of this registration form and enclosed it with my check payment. *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy