REGISTRATION FORM FOR THE ISPCAN GLOBAL INSTITUTE ONLY

Poverty: Child Protection and Children's Rights and Advocacy- Professionals’ and Government Roles

MONDAY, JANUARY 26, 2009, 8:30 AM TO 4:30 PM
TOWN & COUNTRY RESORT & CONVENTION CENTER, SUNSET ROOM, SAN DIEGO, CA

INFORMATION
Prefix(Prof/Dr/Mr/Mrs/Ms)*
First Name:* Last Name (Surname):*
Company/Organization:
Title:
Mailing Address:*
City:* State/Province:
Postal Code:* Country:*
Telephone Business: Business Fax:
Email:*
 
REGISTRATION
$65.00 Student Rate (with current valid student ID)
*Note: to receive this rate, please send a copy of your student ID
by fax (630-876-6917) or email events@ispcan.org
$125.00 ISPCAN Member
$185.00 Non-members
$255.00 New/Renewing Member*
*Includes Year 2009 Membership (regular fee: $150/year)
$65.00 DC Country Special Rate

Check | Purchase Order on Organization’s Form

  Or by Credit Card:  
Mastercard | Visa | American Express | Discover
Cardholder’s Name:
Card #:   Expiration Date:
Security Code:      

Credit Card Billing Address (if different from above):

Mailing Address:*
City:* State/Province:
Postal Code:* Country:*
         

 

Please send non-credit card payments payable to ISPCAN
245 W. Roosevelt Rd., Building 6, Suite 39 | West Chicago, IL 60185
Phone: 630-876-6913 | Fax: 630-876-6917
Membership: membership@ispcan.org | Events: events@ispcan.org | Website: www.ispcan.org/gi2009

 
   ISPCAN Secretariat Office - 245 W. Roosevelt Road Building 6, Suite 39 -  West Chicago, IL 60185 USA - Tel. +1.630.876.6913