Registration for July 21-25, 2008 Leading for Educational Equity Institute Goshen, IN

Please fill in the form below and press the submit button at the bottom. All Information is required.
First name :
Last name :
Position :
Workplace :
Address of workplace :	Street City State Zip
Home address :	Street City State Zip
Summer address : (optional) (if different from above)	Street City State Zip
Home phone (include area code)
Work phone (include area code)
Cell phone (Optional)
Email :
Summer Email (Optional)	(if different from above)
Please describe any CFG expereince you may have.
Please tell us more about yourself and your interest in the seminar.
Billing Information
Who is Responsible for payment?
Bill to the attention of
Billing Address	Street City State Zip
Billing Phone (include area code)
Billing Fax