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Conflict Transformation Symposium Registration

University of North Florida

October4-6, 2007

(Required marked with asterisk *)

Personal Information:

*First Name:   

 M.I:   

*Last Name: 

Name as you would like it to be appear on Name Tag:

Your Organizational Affiliation:   

 

Position or Title: 

*Address:

 *City: 

*State: 

*Zip Code

*Phone:   

Alternate Phone: 

*Email: 

Special Needs

 

Registration Order

(A) REGULAR REGISTRATION: $130;  (Early Bird discount: $110 if registered by August 31).  

(B) LIMITED INCOME: $75;  (Early Bird Discount: $65 if registered by August 31)

(C) STUDENT RATE: $35;  (Early Bird Discount: $25 if registered by August 31)

(D) Requesting Full Scholarship; (UNF Students Only);

     If you are applying for a full scholarship to the Symposium, you are certifying that you

     are currently enrolled as a student at the University of North Florida. If accepted, you

     will be asked to volunteer in some capacity during the events of Peace Awareness Week.

 

(E) SATURDAY ONLY - $45 (Early Bird discount: $40 if registered by August 31) This option include all events of the Saturday program from 8:30am-2:30pm, including a Continental Breakfast and Luncheon;

 

Vendor / Exhibitor

 

My organization would like to be listed as a sponsoring vendor / exhibitor.

 

Click here for Vendor / Exhibitor Information

 

 

None
Gold Level ($500.00)
Silver Level ($300.00)
Bronze Level ($200.00)

  Total Cost:  

Payment Method

I will pay by credit card now

I will mail my check

Order Number: