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U.P. Nonprofit Conference - Online Registration

Participant Registration

Name:
Organization:
Job Title:
Address:
City: State: Zip:
Phone: Fax:
E-mail:
Yes, I am a member of the Great Lakes Center for Youth Development (GLCYD) and am eligible for the discounted registration fee.
I would like to JOIN GLCYD & MNA Now and begin my discounts today!

Conference Registration Rates:

Early Bird (by September 16)
     $50 - GLCYD/MNA Member
     $65 - Non-Member
Regular Registration (by October 6)
     $65 - GLCYD/MNA Member
     $80 - Non-Member
On-Site Registration (space permitting)
     $80 - GLCYD/MNA Member
     $95 - Non-Member
Pre-Conference Sessions on October 6
     Yes, I will attend
  Session Title: Cost:
  $
  $

Payment Information:

Credit Card    Check    Bill My Organization    PayPal

Visa    MasterCard    Card #:    Exp.Date:

                                                                                                       
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