Conference 2012 Registration | Divine Science Federation International

DIVINE SCIENCE FEDERATION CONFERENCE REGISTRATION

One person per registration form, please.

Registration deadline is July 15th.

INSTRUCTIONS
You may register for the entire conference (Standard registration) or for specific days (Wed, Thur, Fri) or for the banquet only.
When you submit your registration you will be taken to the on-line payment screen. You may pay immediately or at a later time.
A copy of your registration will be sent to the email address you provided on this form. You will receive this confirmation whether you pay online or not.

*(denotes required field)

First Name: *

Last Name: *

E-Mail Address: *

Home City *

Home State or Province *

Home Postal Code *

Phone number where we can contact you *

Special dietary need?

Yes No

If you indicate special dietary needs, we will contact you for details

Banquet meal: *

Conference Payments

Yes, I wish to be a Conference Sponsor with an additional donation of ($100 or more USD)

Standard Registration (whole conference)

Wednesday only

Thursday only

Friday only (incl Banquet)

Banquet only

TOTAL AMOUNT paid *

Payment method *

On-line Mail

Cheque number

(if not paying on-line)

Comments / Special considerations or needs (ex: wheelchair)

CAPTCHA Code: *