Registration Form: The Evolution of Revolution

            * If you don't want to use the following web form, a DOWNLOADABLE FORM is available for direct mailing as .pdf file.

Registration

1. Please provide your contact information:

Your Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

* Did someone already register you as part of a group?
Please tell us that person's name so we can locate your payment information:




REGISTRATION PROCESS
GO TO STEP 2A FOR INDIVIDUAL REGISTRATION (up to 9 people)
GO TO STEP 2B FOR GROUPS

2. Conference Registration and Payment

A. Individual Rate (1-9 people) Through June 30, 2008: $325 AGNT Members $350 All others Beginning July 1, 2008: $375 AGNT Members $400 All others Special Individual Rates $275 Ministers $250 Youth (under 25) & International $300 International, including Canada Please Join us for Friday NIght Banquet (Vegetarian) $40 Enter Total Number of Registrants Enter Total Number for Banquet Please Enter Total dollar amount (registration fee plus banquet)

B. Group Rate Bring your friends! Save 30$ per person with groups of 10 or more. Remember that the 11th person is free. Through June 30, 2008: $295 Per Person Beginning JUly 1, 2008: $345 per Person Please Join us for Friday NIght Banquet (Vegetarian) $40 Enter Number of Registrants Enter Total Number for Banquet Please Enter Total dollar amount (registration fee plus banquet)

Please submit the names, separated by commas, of each registrant in your group in the box below.
* The cutoff date for group discounts is September 1, 2008.

* It is important that all members in your group submit their full contact information to us.
They can each do this easily by individually completing section #1 of this form and simply giving name of group leader along with their contact information.

If they wish to participate in the pre-conference intensive event, they should also complete section #3 (below).

3. Pre-conference Intensive payment information

Wednesday, October 1, 2008
 
10am - 4pm (with lunch break)

$100 with conference registration    $150 (not attending conference)

Please select which pre-conference institute you would like to attend. We will send you updated information about attending the pre-conference intensive as the conference approaches. 

Pre-conference Intensives Lynne McTaggart Azim Khamisa Corinne McLaughlin & Gordon Davidson Gay Luce & Deborah Jones, Nine Gates

Intensives are on first-come, first-served basis.

Enter Dollar Amount for Pre-conference: 

4. Grand Total 
Add Total for Registration Fee Plus Banquet and Total for Pre-conference.

* Remember, if your conference registration fee has been submitted by another person, you should pay only for the pre-conference, or leave this area blank.

5. Billing:

Credit Card	VISA MasterCard American Express
Cardholder Name
Card Number
Expiration Date v-code *required (last 3 digits on back of card)

6. Other Comments Here:

7.