University of the Virgin Islands 
Center for the Study of Spirituality and Professionalism 
Office of the President ~ #2 John Brewers Bay ~ St. Thomas, V.I. 00802 
 
SYMPOSIUM REGISTRATION FORM 
for 
“SPIRITUALITY AND HIGHER EDUCATION” 
Friday, April 12, 2013 
 
 
Title 
 
☐Dr.  
☐Prof  
☐Ms.  
☐Mrs.  
☐Mr. 
 
Last Name ___________________________________________________ 
First Name & MI __________________________________________ 
 
Affiliation: _______________________________________________________________________________________________________________________ 
 
Address:  _________________________________________________________________________________________________________________________ 
Street  
 
 
 
 
City 
 
 
 
State 
 
Zip Code 
 
Phone #: ____________________________________________________ 
Alt. Phone #: ______________________________________________ 
 
Email: _______________________________________________________ 
Website Address: _________________________________________ 
 
 
Please complete this form, print and fax or mail or email to the address below. 
~~~ 
University of the Virgin Islands 
Center for the Study of Spirituality and Professionalism 
Office of the President 
#2 John Brewers Bay ~ St. Thomas, V.I. 00802 
(340) 693-1499 (O)   *   (340) 693-1175 (F) 
www.csap@uvi.edu