Mississippi Public Universities
University Research Center
STEP 1: Conference Registration
Date 8/19/2017
   
Title
 
   
First Name
Required
   
Last Name
Required
   
Badge Name
Optional if different than the information entered above: How would you like your name to appear on your badge (include any title i.e. Mr., Miss., Mrs., Dr., etc.)?
   
Affiliation
Required
   
Full-Time Student?
Required: Are you a full-time student?
   
Job Title
Required
   
Primary Email Address
Required: Due to technical restrictions, please do not use a Yahoo.com email address as your primary email. Do not enter more than one email address. Use the Secondary Email Address field for an optional email address.
   
Secondary Email Address
 
   
Add to our email list?
Required: Would you like to receive emails about the Advancing Mississippi conference and The Mississippi Economic Review in the future?
   
Phone Number
 
   
Enter the code below before submitting the form.
   
Please review the form carefully before continuing to Step 2.
   
 
Conference registration is $40 per person until May 1, 2017. After May 1, 2017, registration will increase to $60. Please mail your registration form and payment (check or money order) to Janna Taylor, 3825 Ridgewood Rd, Jackson, MS 39211. Make checks/money orders payable to MS Institutions of Higher Learning. Multiple forms may be mailed in a single envelope with one check. If you have any questions, please email Sondra Collins at scollins@mississippi.edu.