Conference Registration Form The 26the International Conference on Ground Control in Mining (2007 ICGCM) July 31-August 2, 2007 • The Lakeview Scanticon Resort and Conference Center • Morgantown, West Virginia Please print or type—complete a separate form for each participant

Name ______

Title ______

Organization ______*Org.’s FID# ______

Mailing Address ______

City State Zip ______

Phone No. ______Fax No. ______

E-mail ______

Registration fee(s): U.S. $370 before July 13, 2007. U.S. $420 after July 13, 2007 and on-site for Standard Participant Fee. U.S. $100 Student Participant Fee.

Optional fee(s): Free for Monday Workshop Monday pre-reception, Tuesday lunch and Banquet reception, Wednesday lunch, Golfing and BBQ are provided by registration fee and sponsors.

Total Amount: $ ______

Do you have any special dietary needs? Yes___ No____ If yes, what ______

Method of payment: Payment of registration fees is required prior to program attendance. Registration will be processed when payment is received.

Check enclosed (Make payable to: WVU-Department of Mining Engineering)

Credit Card: Visa MC Refund and Cancellation Policy Requests for refunds will be honored when Card No. ______Exp. Date ______received seven calendar days prior to the program. However, another person may be substituted at any time for this conference. Cardholder name ______A $25 administrative fee will be deducted for cancellations. In the unlikely event that Cardholder signature ______Date ______this conference is cancelled or postponed due to insufficient enrollments or unforeseen Return with payment (no staples, tape, or paper clips, please) to: circumstances, the university will fully refund registration fees but cannot be held responsible Department of Mining Engineering for any other expenses, including cancellation College of Engineering and Mineral Resources or change charges assessed by airlines, hotels, West Virginia University travel agencies, or other organizations. For weather or disaster-related program Morgantown, WV 26506-6070 cancellation or postponement information, please phone: 304-0\93-7680 call 304-233-7680. fax: 304-293-5708 (for card registrations only) *Necessary to process a refund payable to any company, agency or government. The information you provide is subject to the Freedom of Information Act guidelines.