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North Dakota Human Rights Coalition Working to effect change so that all people in North Dakota enjoy full human rights |
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2004 Conference Registration Form
Name(s): ____________________________________________________________________ Organization:__________________________________________________________________ Address: _____________________________________________________________________ City: __________________________________________ State: _______ Zip: _______________________ Phone: _____________________________ Email: _____________________________
Registration Fees (Includes conference registration and materials, meals, and breaks)
After October 10 (____x $80) = _________ One-Day-Only (____x $40) = _________
After October 10 (____x $90) = _________ One-Day-Only (____x $50) = _________
Student (____x $40) = _________ After October 10 (____x $50) = _________ One-Day-Only (____x $30) = _________
Elder (50 & over) (____x $40) = _________ After October 10 (____x $50) = _________ One-Day-Only (____x $30) = _________
Total = _____________
Send form with payment to:
North Dakota Human Rights Coalition P.O. Box 1961 Fargo, ND 58107-1961
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North Dakota Human Rights Coalition P.O. Box 1961 Fargo, North Dakota 58107-1961 Phone: (701) 239-9323 Fax: (701) 478-4452 Email: humanrights@ndhrc.org
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