If you would prefer to mail a check for the tour registration, please print this form and mail your check to OAH, PO Box 5457, Bloomington, Indiana 47408-5457. Please remember that space is limited.

Registrants who cannot be accommodated will be placed on a waitlist.

Registrant

First Last

Affiliation E-mail

Guests

How many guests will accompany you?

Additional Information

Do you have a disability and require accommodations to fully participate?
If so, OAH will contact you. Yes No

Thank you for your interest in the tour. We will charge the credit card you provided when you registered for the annual meeting and provide a confirmation for your participation.