Environmental Justice Conference 2008

 

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Registration Form

Please provide information as you wish it to appear on your name badge and in the list of participants. A separate form must be completed for each participant. When ready to register, scroll to bottom of page and click "Buy Now." Complete the Paypal form, pay the registration fee and you are registered in the conference. If the registrant is not the card holder or the individual completing the registration, please place the registrant's name on the first address line on the registration form.


Registrant Fee: $150.00 (Online only - on or before May 7, 2008)


Registration after May 8, 2008: $250.00 (On-site only - please bring completed registration form to conference)


Full-Time Students Free (Does not include meals) - To register as a student, click here.


  • To register online, Scroll to Bottom of Page and Click "Buy Now." Complete the Paypal Form and pay the registration fee. Once the fee is Paid, you are Registered for the conference.



____Ms _____Mrs. _____ Mr. ____Dr. ____Hon. ____Other (please specify)


Name______________________________________________


Institution, Agency, Company, organization or Affiliation


Address_________________________________________________________


City_______________________ State___________Zip Code_____________


________________________________________________________________


Phone:

Fax:

E-Mail:




To Pay Online: Click Below
Sponsors: Click Below to Pay
Note: Because of the chemical sensitivity of many people, we are requesting that attendees wear unscented toiletry items.