PLACEMENT SERVICE REGISTRATION FOR INTERVIEWING DEPARTMENTS APA 2007 CENTRAL DIVISION MEETING THE PALMER HOUSE HILTON, CHICAGO, IL. APRIL 18-21, 2007

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 Central 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 Indicate Quantity of Tables)

need interviewing ______ table(s)

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: (Please Check One)

______ Pre-Registration, By March 21: $50.00

______ *Regular Registration, After March 21: $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 March 21, 2007, 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