2012 Annual Conference Registration by Mail

2012 USNC-UN Women Annual Conference and Member Meeting

Women Lead:  Politics, Civil Society, and Peacebuilding Worlwide

June 2, 2012
George Washington University, Marvin Center
 
 
TO REGISTER BY MAIL, PLEASE COMPLETE THIS FORM AND SEND IT WITH YOUR CHECK OR CREDIT CARD INFORMATION TO USNC-UN Women, 1120 20th Street NW, #720, Washington, DC  20036

  First name: *
Last name: *
Email: *
Address Line 1: *
Address Line 2:
City: *
State: *
ZIP/Postal Code: *
Country (if not US): *
Telephone:*
 
Type of Registration (please select one):

__  $100.00  USNC-UN Women Member
__  $125.00  Non-Member
__  $  50.00  Student 


__  I will  attend Congressional Education Day
__  I will not attend Congressional Education Day
    

Payment Method:

__  Check payable to USNC-UN Women is enclosed
__  Charge my credit card
 
Cardholder Name:*     
Billing Address (if different than above):*          




Telephone Number:*
Card Type:*                   
Card Number:*             
Security Code: *           
Expiration Date:*           
 


If you have questions, please email   or call 202-939-2675.