North Dakota Human Rights Coalition
Network Conference
Registration Form
The registration fee is $25 and includes
conference materials
and lunch. Please register no later
than Friday, October 17th.
Name:
_______________________________________
Address:
_____________________________________
City:
________________________________________
State: ______ Zip:
____________________________
Phone:
_______________________________________
Email:
_______________________________________
Please indicate the name you would like on
your
name
badge:___________________________________
Makes checks payable to NDHRC. Please mail
your
registration form and check to:
North Dakota Human Rights Coalition
P.O. Box 1961
Fargo, ND 58107-1961
Break-out Sessions
I will be attending the following break-out sessions:
____ 10:15 AM – 10:55 AM – Role of Media in Human
Rights Efforts
Sign: ________________________________________
Date: ___________________
Accommodations Checklist
Please contact us at (701) 239-9323 or
humanrights@ndhrc.org for any accommodations that you may need (i.e.
conference materials in Braille or an interpreter), or if you will be using
a wheelchair at the conference (to ensure appropriate space accommodations
during the conference).
