REGISTRATION FORM

CONSUMER SATISFACTION, DISSATISFACTION AND
COMPLAINING BEHAVIOR CONFERENCE
LA VERNE, CALIFORNIA
June 20 - 24, 2012

Conference Hotel: The Doubletree, Claremont, CA
 Site for Sessions: University of La Verne, La Verne, California
[Papers will be delivered in the Campus Center Building]

Your name as you wish it to
appear on your name badge

 

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Your affiliation as you wish it
to appear on your name badge

 

__________________________________________________________

Mailing Address

 

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

E-Mail

________________________________

Phone Number  

_______________________________
Registration Fee: Early (Received on or Before May 15, 2012) = $325 ($225 for graduate students)
Late (Received after May 15, 2012) = $375 ($250 for graduate students)
Payment Method:
(Please check form of payment)
__Check in U.S. Dollars drawn on a U.S. Bank (made payable to “CSD&CB”); or
__Credit Card (MasterCard or Visa only); please complete the information below:
   
  Card Number:     ___ ___ ___ ___ - ___ ___ ___ ___ - ___ ___ ___ ___ - ___ ___ ___ ___
  Expiration:     ___ - ___ /   ___ - ___   
Your Name as it appears on the credit card:   ______________________________________________

Hotel Information:  Please make your hotel reservations with The Doubletree in Claremont, CA (call toll free at 1-800-222-TREE, call the hotel directly at 1-909-626-2411, or make your reservation online by visiting www.doubletreeclaremont.com).  To secure the special group rate of $114.00/night mention the CSD&CB Conference [use Group Code CSD] and reserve your room by May 15, 2012.   For those wishing to extend their stay, these rates, pending room availability, will apply 2 days prior to and 2 days following the conference.

Please Note:  Your conference registration fee covers all sessions, lunch on 6/21, 6/22 & 6/23, beverages for all breaks, a CD of the conference proceedings, and the Friday evening (6/22) picnic.

E-mail or Fax This Form to:
Stephen Goodwin
Editor, Journal of Consumer Satisfaction,
Dissatisfaction and Complaining Behavior
Department of Marketing
Illinois State University
Normal, IL 61790-5590
E-Mail sagoodwi@ilstu.edu   
Fax 309-438-3508