Saturday February 28, 2004
9:30 am to 4:30 pm
International House of Philadelphia
3701 Chestnut Street
Mail this registration form with your check
payable
to the Center for Responsible Funding to
924 Cherry Street, Suite 520, Philadelphia, PA 19107.
Deadline for registration is February 26, 2004.
No refunds for cancellations within 48 hours prior to this event.
We cannot accept credit cards.
Cost: $70 x _____= $__________
($70 each for first two registrants from
an organization)
$60 x _____= $__________
($60 each for additional registrants from an organization)
Total _____= $__________
Use additional sheet if necessary
__________________________________________________
1st Name
__________________________________________________
Title
__________________________________________________
2nd Name
__________________________________________________
Title
__________________________________________________
3rd Name
__________________________________________________
Title
__________________________________________________
Organization
__________________________________________________
Address
__________________________________________________
City/State/Zip
__________________________________________________
Phone
__________________________________________________
Fax
__________________________________________________
E-mail
Contact person: Miriam
Pineiro-Cortes
215-925-6140 (Phone)
215-925-4933 (fax)
trainer@responsiblefunding.org