4th Annual CASS Conference - Registration Form
UNITED IN DIVERSITY - How unity works in a divided nation
October 12 - 14, 2018
Holiday Inn Airport - Bloomington, MN
Full Name *
Title *
Organization *
Address 1 *
Address 2 *
City *
State *
Email *
Phone number *
I am... *
If needed, are you willing to be a volunteer during the conference
Clear selection
Emergency Contact information (Please include name, relationship to you such as "wife", phone number, email address) *
I understand that I am responsible for my own travel and accommodations for the conference *
Required
To help cover the cost fo the conference (light breakfast and lunch included) please make a suggested registration fee of $25 through PayPal ( https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=CRKPLF236VUE6 ). Thanks *
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