REGISTRATION FORM

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Midwest Facilitation Network
(http://www.midwest-facilitators.net)
41st Midwest Facilitation Conference
Monday, October 16, 2006

Send to Registrar:  E-Mail:    register@midwest-facilitators.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

 

41st Midwest Facilitation Conference @ Chicago Indoor Racing
Buffalo Grove, Illinois (NW Chicago Suburb) - Monday, October 16, 2006



________________________________________
Name


Full Conference Registration:
(by 10/11: $110 - after 10/11: $125 - on site: $135)
$__________
________________________________________
Company


Half-day Conference Registration:
(by 10/11: $75 - after 10/11: $80 - on site: $85)

$__________
________________________________________
Address & Mail Code


________________________________________
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 10/11 or no shows may be assessed a cancellation fee



(Location / Conference Agenda / Conference Information / Travel Suggestions / Lodging Suggestions)
(About the Presentations / MFN Contacts / Upcoming Events/Notices / Registration Information)
Top Conference Announcement  /  MFN Home Page