2001 TACSM Annual Meeting Registration

Please provide the following contact information.  Use "Tab" to move between fields.  After you have completed the form, please print a copy of this form by choosing "File" from the browser toolbar and then "Print".  Please send this form along with your check to:

Joel Mitchell, TACSM President TACSM Annual Meeting TCU Box 297730 Fort Worth, TX 76129

Name

Position

Institution

Street Address

Address (cont.)

City

Zip/Postal code

State

Work Phone

FAX

E-Mail

Are you a current member of National ACSM?

NO

YES

Are you a ACSM Fellow?

NO

YES

REGISTRATION FEES (including Fri and Sat lunch)

Before Jan 26      After Jan 26

TACSM MEMBERS

Full-time Student and Professional-in-training          Faculty Supervisor _________________ Professional

$30                    $45

$60                    $75

NON-TACSM MEMBERS (includes membership)

Full-time Student and Professional-in-training          Faculty Supervisor  ________________ Professional

$45                    $60

$90                    $105

**Please makes checks payable to TACSM.    Registration must be postmarked by 1/26 for reduced fee.