DIAC-97
Registration Form

 

| Program | Workshops | Committees | Registration | Co-Sponsors & Supporters | Benefit |

Print, fill out and mail with your payment to the address at the bottom of the page.

Name

Address

City, State, Zip

Country

Phone

E-mail

Registration Fees (choose one)
 CPSR Member - $50
 Co-Sponsoring Organization - $50
      Which organization? 
 Regular - $75
 Student / Low Income - $25
 Sunday Workshops only - $25

Lunch (optional. choose one)
 Saturday Lunch - $12
 Sunday Lunch - $12
 Saturday & Sunday Lunch - $20

 

Please print, fill out and mail this form with your check to:

CPSR / Seattle - Conference Registration
P.O. Box 85481
Seattle, WA 98145-1481
USA

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Last updated February 9, 1997
Please address comments or questions
about this site to David Suwal