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Midwest Facilitation Network
(http://www.midwest-facilitators.net)
39th Midwest Facilitation Conference
Monday, January 23, 2006

39th Midwest Facilitation Conference @ Catalyst Ranch
Downtown Chicago, Illinois - Monday, January 23, 2006

________________________________________ Name	Full Conference Registration: (by 01/17: $110 - after 01/17: $125 - on site: $135)	$__________
________________________________________ Company	Half-day Conference Registration: (by 01/17: $75 - after 01/17: $80 - on site: $85)	$__________
________________________________________ Address & Mail Code	Full-day participants mark session choices:  2: A - B    3: A - B    4: A - B Half-day participants (lunch included) mark session choices: 2: A - B    or    3: A - B    4: A - B
________________________________________ City/State/Zip	_________-_________-_________-_________ Visa-MasterCard-American Express-Discover-Diner's Club
________________________________________ Business Telephone                              Business Fax	_______________________    _________   _______ Signature                                 Exp Date         VCODE
____________________________________ E-Mail Address                                      Website	___________________________________ Your Company Purchase Order # for Billing
	Cancellations after 01/17 or no shows may be assessed a cancellation fee