Registration - Colloquium
on Global Diversity March 3-4, 2011
PAYMENT BY
CREDIT CARD
This online form is for use with credit
card payment only . We do accept checks, but are not able to accept checks
for registrations online.
To pay by check, you will need to
print the registration form and mail it with your check to our office.
REGISTRANT INFORMATION
REQUIRED FIELDS
Ms.
Mrs.
Dr.
Mr.
First Name
Last Name
Title/Position
Company
Mailing Address1
Mailing Address2
INCLUDE CITY, STATE, ZIP CODE Country
Tel (include country code)
Fa x
E-mail
Re-enter E-mail
REGISTRATION FEE
We cannot process your registration
without payment either by credit card or bank check.
US
$450 -
( includes March 3 Dinner Roundtables and March 4Colloquium)
No refunds after February 10, 2011
METHOD OF PAYMENT
REQUIRED FIELD Note:
All credit card charges will be
processed by WREI
Pay by Bank Check
(note: this process
cannot be completed online)
CREDIT CARD PAYMENT
Cardholder Name
Card Type
Select
American Express
Mastercard
Visa
Account Number
Expiration Date (Month/ Year)
Signature of Cardholder
Important Note: The Global Summit of Women is a non-profit
program whose fiscal agent is WREI (Women's Research and Education
Institute) (USA). All credit card charges will be processed
by WREI.
CANCELLATION POLICY: Notice of cancellation must be submitted in
writing prior to February 20, 2011. Please email
your request to
summit@globewomen.com. In order to be honored,
requests for refunds must be received prior to the February 20, 2011
deadline.
HOTEL
ACCOMMODATIONS:
Melrose Hotel:
A special rate of $195 + tax
is available for Colloquium participants.
Please call 1-202-955-6400 or email
david.work@melrosehoteldc.com
before
February 10 and
reference the
Global Summit of Women to receive the discounted
rate. The hotel is
located at 2430 Pennsylvania Ave., NW Washington , DC
SUMMIT OFFICE -
CONTACT INFORMATION Mailing address: Global Summit of Women
1100 G Street, NW, Suite 700 Washington, DC 20005 USA
