REGISTRATION FORM

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Midwest Facilitation Network
(http://www.midwest-facilitators.net)
24th Midwest Facilitation Conference
Monday, October 23, 2000

Send to Registrar:    E-Mail:        pcollins@jordan-webb.net

                               Tel:            (773) 463-2288

                               Fax:           (773) 463-1830

                               Snail Mail:   MFN c/o Jordan-Webb
                                                  2656 West Montrose Ave  - Suite 110
                                                  Chicago, IL 60618
 

24th Midwest Facilitation Conference @ Loyola University Chicago - Water Tower Campus
 

_____________________________________ Conference Fee: $85/registrant: $ ____________
 Company                                                          (After October 16th: $95)

_____________________________________
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 / MFN Contacts / Upcoming Events/Notices / Registration Form)
Top Conference Announcement  /  Back to MFN Home Page