Sharing Our Stories: The Second Wave Feminist Movement
Friday, March 31
Hilton Durham (near Duke University), Durham, NC
Name: First_____________________________ Last_____________________________
City, state, zip___________________________________________________________
Indicate your registration below:
______ Reception at Sallie Bingham Center 3/30, no charge
______ Conference* only, $60 per person
______ Reception and dinner only, $50 per person
______ Conference* and dinner, $110 per person
______ Conference* and dinner, $105 for VFA members
______ Check here to request vegetarian meals
Summary of charges
$______________ Conference registration as indicated above
$______________ VFA membership ($50 annually)*
$______________ Donation to defray event costs for those unable to pay*
$______________ Additional donation to support the work of VFA*
$______________ Total *tax-deductible
Please indicate which payment option you prefer:
_______ Check enclosed made out to VFA.
_______ Credit card (Visa or MasterCard)
Name on credit card_____________________________________________________
***A limited amount of financial assistance is available. If you would like to attend the conference and/or the awards dinner but need financial assistance, please send an email describing your situation to email@example.com.
Print out the form, indicate form of payment and mail to:
813 Mission Creek Drive
Palm Desert, CA 92211
Form and payment must be received no later than March 27
Please be sure to send in a registration form regardless of your form of payment. If you are paying by credit card, you may scan and email this form to firstname.lastname@example.org.
Photo/Video/Audio Consents and Permissions
By registering for the VFA conference, I grant permission to VFA and consent to its taking photographs or videos of me or audio recordings of my voice at the event to use, exhibit, display, broadcast and distribute in VFA's sole and absolute discretion, in whole or in part, for profit or otherwise, in any media now known or hereinafter devised, without further consideration, permission, consent or agreement.