The Colonial Society of Massachusetts and
The Center for Historic American Visual Culture at the American Antiquarian Society
Worcester Polytechnic Institute

Fields of Vision: The Material and Visual Culture of
New England, 1600-1830

November 9 & 10, 2007
Worcester, Massachusetts

Registration

Please mail the form below together with your payment to the American Antiquarian Society, 185 Salisbury Street, Worcester, Massachusetts 01609-1634

Name(s):

Address line 1:

Address line 2:

City:                                                                             St:                    Zip:

Phone:                                                                          Email:

Affiliation:

Preferred name for badge:

FEES
            Registration fee, $25.00                                                  _________

            Saturday lunch, $12.00                                                   _________

            Conference banquet (Friday, November 9), $ 65.00           _________
             
                                                                      Total                  ________

PAYMENT

  Check enclosed for total amount of $ ________

  Charge my credit card $__________

  VISA               MasterCard                     Discover      American Express

Card holder name:

Card number:                                                               Exp date:

Signature:

Registration and payment are due by Friday, October 26, 2007.