Name:__________________________________________________________________________________
Title:___________________________________________________________________________________
Institution:_______________________________________________________________________________
Address:________________________________________________________________________________
City:_________________________________ State:___________________ Zip _______________________
Telephone:(Office)_________________________________ (Home)__________________________________
Fax:_________________________________ E-mail:_____________________________________________
Lunch preference:___________Regular_________ Vegetarian
_______________________________________________________________________________________________________________________
Fax Registration Form To:
817-257-7373
or
Mail Registration Form To:
Dr.
Cornell Thomas
Special Assistant to the Chancellor
Texas Christian University
P.O. Box 297090
Fort Worth, TX 76129
817-257-7796
c.thomas@tcu.edu