REGISTRATION FORM

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Midwest Facilitation Network
(http://www.midwest-facilitators.net)
22nd Midwest Facilitation Conference
Friday, January 28, 2000

Send to Registrar:    E-Mail:        pcollins@ais.net

                               Tel:            (847) 673-2288

                               Fax:           (847) 673-9322

                               Snail Mail:   MFN c/o Jordan-Webb
                                                  3700 West Devon Ave  - Suite F
                                                  Lincolnwood, IL 60712
 

22nd Midwest Facilitation Conference @ De Paul University - Downtown Campus
 

_____________________________________ Conference Fee: $65/registrant: $ ____________
 Company                                                            (After January 21st: $70)

_____________________________________
Name

_____________________________________
Address & Mail Code

_____________________________________      ___________-___________-___________-___________
City/State/Zip                                                                             VISA / MASTERCARD NUMBER

_____________________________________      __________________________________ _____/_____
Business Phone                                  Home Phone             Signature                                                                 Exp Date

_____________________________________      _____________________________________________
E-Mail Address and Website Address                                       Your Company P O Number for Invoicing

(Location / Conference Agenda / Conference Information)
(About the Presentations / Upcoming Events/Notices / MFN Contacts)
 Top Workshop Announcment / Back to MFN Home Page