Annual Conference
Welcoming All Who Are Interested in History
Historic Baker University, Baldwin City, Kansas, April 22-23, 2016
Registration Form

The conference runs 12:30-8:00pm Friday and 8:00am-1:30pm Saturday throughout the campus at Baker University. It includes four paper/presentation sessions with multiple panel options, one dinner speaker, two meals, two breaks with snacks, and coffee. Please use one form for each attendee, but if multiple attendees are being paid with one check or purchase order, send the forms together and indicate total on only one of the forms. Membership in KAH is included in the registration.

Please print clearly.
Name (as you want it on the name tag) _________________________________________________________________________________________________

Organization (i.e. college name, if relevant) ________________________________________________________
Address, including city, state, and zip ___________________________________________________________
__________________________________________________________________________________________Telephone/s _______________________________________________________________________________
E-mail address _____________________________________________________________________________
Dietary and/or access concerns/needs ___________________________________________________________

Please check the one that applies for this registrant (there is no rate for single days and there are no refunds):

_____ General Early Registration $35 ($45 after 4/1/16 postmark)
_____ Student Early Registration $25 ($35 after 4/1/16 postmark)

______ Friday Dinner Saturday Business Lunch ______ (Please check if attending)

TOTAL AMOUNT ENCLOSED $_______________

Mail this form, with your check payable to Department of History, Culture & Society, to:
Dr. Leonard Ortiz, P.O. Box 65, Baldwin City, KS 66006-0065
For more about registration, schedule, meetings, access, or food:
Dr. Leonard Ortiz (785) 594-8482 lortiz@bakeru.edu
For more about paper sessions:
Dr. James Leiker, 913-469-8500, ext. 3673, jleiker1@jccc.edu
Recommended Lodging: Three Sisters Inn, Baldwin City; The Lodge, Baldwin City; Comfort Inn, Ottawa; Super 8, Ottawa; Best Western, Ottawa; Econo Lodge, Ottawa (all 15 minutes from Baldwin)