Registration Form — Deadline April 30, 2007

Second Biennial Symposium on American Culinary History

Please print or type. Complete a separate form for each person attending. Attendance is limited. Registrations are accepted in the order received.

Name _________________________________________________Today’s Date  ____________

Title or Affiliation________________________________________________________________

Address _______________________________________________________________________

City__________________________________________________State____Zip  _____________

Daytime phone number________________ Email address_______________________________

Registration fee: $175.00

Includes all lectures and coffee breaks Friday and Saturday, Friday night reception, and Saturday box lunch provided by Zingerman’s and sponsored by the Wisconsin Milk Marketing Board.

Symposium Costs                                                          

□ Registration fee                                                                                          $175.00

Optional fees

           □ Saturday Banquet. Select one:   □ chicken    □ beef   □ vegetarian             $75.00

           □ Sunday Zingerman’s Brunch and Tours                                                 $50.00

□ I would like to make a separate contribution to support the work and

mission of the Longone Center for American Culinary Research.     $__________

TOTAL AMOUNT ENCLOSED                                                                       $__________                                                                                                                                                          

Payment Options        

□ Check enclosed (payable to William L. Clements Library)

□ Credit card (Visa, MasterCard, Amex, Discover) Number________________________ $________

Exp. date___________ Signature as it appears on card____________________________________

Return form with payment to: Attn. Culinary Symposium, Clements Library, University of Michigan, 909 S. University Ave, Ann Arbor, MI 48109-1190. Or fax completed form with credit card information and signature to: 734-647-0716. No refunds after May 7, 2007.