________________
NAME (Underline family name)
How name should appear on registration badge
Organization (If any)
Address
City
Country
REGISTRATION FORM
(1999 PARLIAMENT OF THE WORLD'S RELIGIONS Cape Town, South Africa (December 1-8 1999
Before March 30, 1999
After March 30, 1999
FEDERATION OF JAIN ASSOCIATIONS IN NORTH AMERICA (JAINA)
State/Province
(Please circle appropriate Dollar amount) (FULL REGISTRATION
Phone
REGISTRATION INFORMATION
All registration allows admission to all regular sessions of the Parliament (including seminars and workshops). December 1- 8 1999. There may be admission charge for some off site cultural events, exhibits etc. Full registration does not include travel, accommodations, or meals. Refunds (less $25 for administrative costs) will be made upon request Until October 31, 1999. After this date no refunds will be given.
(THREE DAY REGISTRATION
(Single person. No discounts)
FAX
$225
Jain Education Intemational 2010_02
$300 $350
Postal Code
INDIVIDUAL RATES
FAMILY REGISTRATION for couples and/or parent(s) with children. Parents, Please note: most indoor sessionsare not appropriate for children under 12 years of age. You are responsible for your child's care at all times. Write the names of each additional person, relationship, and age. (Attach additional sheet if necessary.)
Family member name
Relationship Relationship
Family member name
GROUP REGISTRATION is available when 8 or more persons register together. Please attach extra page(s) SENIOR CITIZENS, (sixty and over) and STUDENTS (22 and under) can register at the flat rate of $200/person. Qualifying students must include photocopy of valid student ID.
E-mail (optional)
Age
Age
(ONE DAY REGISTRATION
$100
(Single Person, no Discounts)
(DATES)
Make checks payable to the Council for a Parliament of the World's Religions
Total Due (all registration fees)
Name of cardholder
Card expiration date
(DATE)
FAMILY OR GROUP RATES $200/person $250/person
Method of payment () Check () VISA () MasterCard Card #
Signature
MAILTO: Dr. Rashmi Gardi, 39 PENTWATER DR., S. Barrington, IL 60010 Phone: 847-428-4298
OPTONAL INFORMATION We'd like to know more about participants in the 1999 Parliament of the World's Religions. If you wish, you can assist us by filling out this portion of the registration form.
Vital statistics: Age Gender () M Dietary Preferences: () No restrictions () Vegetarian (Religion Accommodation (Where you plan to stay in Cape Town) ( ) Private Home ( ) Hotel
()F
For Private & Personal Use Only
Profession
() University Housing () Bed and Breakfast () Other
Note: CPWR is not responsible for making arrangements for accommodations. If you wish, you may make these arrangements through African Travel, Inc. 1100 E. Broadway GLENDALE, CA 91205
Tel: (818) 507-7893 OR (800) 727-7207
Fax (818) 507-5802
Email atilax@aol.com
www.jainelibrary.org
