REGISTRATION FORM

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Midwest Facilitation Network
(http://www.midwest-facilitators.net)
25th Midwest Facilitation Conference
Friday, January 12, 2001

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
 

25th Midwest Facilitation Conference @ Summit Executive Centre - Downtown Chicago
 

_____________________________________ Conference Fee: $85/registrant: $ ____________
Company                                                                                                                               (on or before January 5th)

_____________________________________ Late Registration Fee: $95/registrant: $ ____________
Name                                                                                                                                                             (after January 5th)

_____________________________________ Walk-In Registration Fee: $100/registrant: $ ____________
Address & Mail Code                                                                                                                                            (payment at the door)

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

_____________________________________      __________________________________ _____/_____
Business Phone                                  Work Fax                      Signature                                                                 Exp Date

_____________________________________      _____________________________________________
E-Mail Address and/or  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