Assembly Registration 

Please complete the registration form below

Don't forget to make you reservation at the Bishop Lodge

*First Name:  
Middle Initial:  
*Last Name:  
*Preferred First Name 
For Badge 		 
*Contact Phone:  
*Contact Email:  
*Member Organization:

*Other:

 
*Address 1:  
Address 2:  
*City:  
*State/Province:
*Zip/Postal Code:    5-digits only
*Country:

Registration Type & Fees

 UCGIS Member
$350.00		 Other
$395.00		 Invited Guest
$0.00		 Retired faculty or staff from member institutions
$175.00		 Students
$100.00

Payment Type:

 Credit Card Check Other/NR

Question/Comment
Please press the Submit Registration  Button  to preview your registration information, If a fee is required you will be sent to a secure server to make your payment online with your credit card (American Express, VISA, MasterCard or Discover Card).