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Deep Delta Civil War Symposium Registration

Thank you for registering for the Deep Delta Civil War Symposium! For questions, please call us at 985-549-2109 or email us at: hips@selu.edu.

Fields marked with an * are required.

Participant Information

- Participant First Name: *
- Participant Last Name: *
- Wnumber: Southeastern Students Only
- E-mail Address: *
- Street Address: *
- City: *
- State: *
- Zip Code: *
- Primary Phone# (include area code) *

Adult Guest/Child Information

- Adult Guest/Child First Name:
- Adult Guest/Child Last Name:
- Street Address:
- City:
- State:
- Zip Code:
- Primary Phone# (include area code)

Program Information

- Pricing:
  Please check option(s).*
  
  Pre-registration Deadline: 5:30p.m. Thursday, May 31
- This field is required. Please select an option(s).
- Pre-registration Regular $150
- Pre-registration Adult Guest $100
- Pre-registration Child $25
- Pre-registration Southeastern Faculty/Staff w/ ID $25.00
- Pre-registration Southeastern Student w/ ID $10.00
- Regular Registration
- Registration Regular $175
- Registration Adult Guest $125
- Registration Child $50
- Registration Southeastern Faculty/Staff w/ ID $50.00
- Registration Southeastern Student w/ ID $20.00

Payment Information

- Credit Card Type: *
  This field is required. Please select an option.
- Master Card
- Visa
- Discover
- Other
- Other Credit Card:
- Name on Credit Card: *
- Credit Card Number: *
- Expiration Date: *
- Three Digit code on back of card: *
- Total amount to charge on my credit card: *
- Yes, please process my payment! *

- By Mail: Make checks payable to SLU Controller's Office and mail to Deep Delta Civil War Symposium, Department of History and Political Science, Southeastern Louisiana University, SLU 10895, Hammond, LA 70402.
- Teaching American History Grant: Participants can email: Ann.Trappey@tangischools.org about eligibility for the grant to pay their Symposium fees.
- For more info call 985-549-2109 email us at: hips@selu.edu. . Faculty contributions and student fees help make the Symposium possible. Reduced rates for Southeastern IDs are not subsidized with other participants' fees.

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