Placement Service

Registration for Interviewing Departments

APA 2006 Eastern Division Meeting

Marriott Wardman Hotel, Washington, D.C.

December 26-30, 2006

Only one form is required for each interviewing department.

Institution: ___________________________ Department: __________________
Contact: _____________________________ Phone: ______________________

City, State: _____________________________Email: _____________________

All persons conducting interviews should be registered** for the Eastern Division Meeting as well as the department being registered with the Placement Service.

**Registered members of the department who will be conducting interviews:

__________________________________________________________________ __________________________________________________________________

__________________________________________________________________

Our department will: (Please Check)

____ need interviewing table(s) ______ Quantity of Tables

____ conduct interviews in a hotel suite (you must contact Linda Smallbrook to reserve a suite)

Our department will: (Please Check)

____ provide suite # and list of prearranged candidates to whom suite information may be given

–or–

____ bring suite # and allow service to give to anyone who requests it

Our department will: (Please Check)

____ conduct prearranged interviews only

–or–

____ accept interview requests on-site

Position advertised where? (Check All Applicable)

JFP issue number in which your ad ran: ______________________________________________

Fees: ______ Pre-Registration, By December 5: $50.00

(Please Check One) ______ *Regular Registration, After December 5: $75.00

Credit Card Type: (Circle One) VISA / MASTERCARD

Credit Card #: 

Exp. Date/ Last 3 digits on back of card: 
(can be faxed to (302) 831-8690)

Name on Card: _________________________________ Phone #:____________

Signature: _____________________________________ Email: _____________

***Check #: ______________ Check Date: _____________Check Amount_____

***Payable to: The American Philosophical Association. The APA only accepts checks drawn on U.S. banks in U.S. funds, or Int’l. Money Orders in U.S. funds. There is a $30 charge for all returned checks. **If PAYMENT is not received in our office by December 5, 2006 you MUST pay the on-site fee! Please mail form and payment to: Attn: Lindsay Palkovitz, Placement, The American Philosophical Association, 31 Amstel Avenue, University of Delaware, Newark, DE 19716