MALCA Conference

Wake Forest University

Winston-Salem, North Carolina

April 20-23, 2006


Illness, Madness and Criminality

in Austrian Literature and Culture




German and Russian Department

P.O. Box 7353

Winston-Salem, NC 27109-7353


Conference Pre-registration Form

Print out, complete, and mail to above address by April 1, 2006


Attendee’s Last Name:                                                                                                            

Attendee’s First Name:                                                                                                            

Attendee’s Preferred Mailing Address:                                                                                                                                                                                                                                     

Attendee’s Email Address:                                                                                                       

Attendee’s Fax Number:                                                                                                          

Multi-Media Requests for Your Presentation:                                                                                                                                                                                                               


Conference payment

U.S. participants:  $100 pre-registration fee before April 1, 2006.  After April 1, $115.  Must send check drawn from a U.S. bank.  Please make checks payable to German and Russian Department, Wake Forest University.  Include the name of the conference attendee on the check.  Send to address above.


Based outside the U.S.:  You may pay your $100 fee at the conference if you submit this form by April 1, 2006.  At the conference, the fee will be payable in U.S. dollars or check drawn from a U.S. bank – no foreign currency can be accepted.


Note:  All attendees must be members of MALCA. If you are not a member, please visit the MALCA website for membership forms and dues information.


Vegetarian food preferred:  _______yes     _______no

(Vegetarian food may contain eggs and dairy products.)