Academy of Criminal Justice Sciences

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Online Registration

Online Pre-Registration Deadline: January 15, 2014. All registration after that date must be done on-site at the conference.

Participant Contact Information (Annual Meeting name badges will be printed using the information in the First Name, Last Name, and Institution fields.)

First Name*

Last Name*

Title

Institution*

Telephone*

Fax

Email*

Alpha Phi Sigma Member/Alumni (please check if applicable)

Primary Address

Primary Address*

Primary Address 2

Primary City*

Primary State/Province*

Primary Zip/Postal Code*

Primary Country*

Registration Fee

Member Pre-Registration

Deadline

1/15

Fee

$90.00

Non-Member Pre-Registration

Deadline

1/15

Fee

$140.00

Student Pre-Registration

Deadline

1/15

Fee

$30.00

         Please fax proof of student status (ID or transcript) to 301-446-2819 or
         email to adminassistant@acjs.org. All Graduate Student registrations include a
         one-year membership to ACJS. The offer is available once per
          individual. Please be sure to provide proof of graduate student status
         when registering. If you have taken advantage of the Free Ph.D. Student
         Membership, you are not eligible for this offer.

Senior Citizen Pre-Registration

Deadline

1/15

Fee

$50.00

Please fax proof of senior citizen status to 301-446-2819, or email to
adminassistant@acjs.org

Spouse Pre-Registration

Deadline

1/15

Fee

$50.00

Spouse First Name

Spouse Last Name

Billing Address

Billing Address same as Primary Address

Billing First Name*

Billing Last Name*

Billing Address*

Billing Address 2

Billing City*

Billing State/Province*

Billing Zip/Postal Code*

Billing Country*

Billing Telephone*

Billing Email*

Payment Method

Card Type*
Card Number*
Expiration Month*
Expiration Year*
CVV2*	What's this?
Name on Card*