Sustainability and Higher Education Conference

October 21-23rd (Thurs.-Sat.), 2004 – Portland, Oregon

REGISTRATION

Please print out form, complete, and mail or fax with payment to address below.

Name (to appear on nametag):                                                                           

Position or title:                                                                                                 

Department:                                                                                                      

Institution or organization:                                                                                 

Mailing Address:                                                                                                

Phone:                                         Email:                                                            

Special requests (dietary, accessibility, etc.):                                                       

Would you be willing to serve as a session chair?                                                   


Registration Category

Before 9/10

After 9/10

Amt. Paid

EFS West members
(regular & group):

$90 x      

$120 x      

=

$          

Non-members:

$125 x      

$155 x      

=

$          

Student members:

$40 x      

$70 x      

=

$          

Non-member students:

$55 x      

$85 x      

=

$          

Required meal fee:

$15 x      

$20 x      

=

$   20    


Total Registration Fee:


$          

Meal fee covers Thursday dinner, Friday lunch and dinner, and Saturday lunch (breakfasts not included). Vegetarian options available at all meals. Field trips require separate registration (see "Field Trips").

Refund Policy: Refunds for cancellation, minus a $25 processing charge, will be honored when requested in writing prior to October 15. No refunds will be made after that date.

For credit card payment please provide the following (your statement will show a bill from "communityroom.net", which processes credit card payments for Second Nature):

Name on credit card:                                                                                        

Account #:                                                                                                      

Type (VISA, MC, etc.):                            Expiration Date:                                   

Your Phone #:                                                                                                 

Credit Card Billing Address:                                                                                


Please make checks payable to "Second Nature" (EFS West's partner) and mail or fax (credit card payment only) to:
S. Tierney (EFS Conference)* College of Arts & Sciences * Univ. of Portland * 5000 N. Willamette Blvd. * Portland, OR 97203-5798. * Fax: (503)943-8079 * Phone: (503)943-7760 * Email: info@efswest.org