Location: Washington Plaza Hotel
     10 Thomas Circle, NW (intersection of 14th St & Massachusetts Ave)
     Washington DC 20005
     Phone: 1-800-424-1140 or 202-842-1300

Registration Information:

To register, please send this form along with a check, money order, or credit card information to the address below.  If registering by fax, please fax a copy of your check with this form and then mail the originals to the address below.

Name (as it appears on your credit card if paying by charge):   ____________________________________

Address (billing address if paying by credit card):   ____________________________________
 

Phone:   ____________________________________

Fax:   ____________________________________

E-mail:   ____________________________________
 

Registration Fee:

$100    Conference & Reception--All Events
$25      Student/Intern Rate--All Events
$10-99  Sliding Scale for Conference Only
$15      Evening Reception on 10/15 Only
$10-50 One-Day Sliding Scale for 10/14 OR 10/16
 

Indicate Method of Payment: Check, Master Card, Visa, or American Express

Credit Card Number:   ____________________________________

Complete Expiration Date:   ____________________________________

SIGNATURE if paying by credit card: ____________________________________
 
 
 

Mail to: NOW Foundation
Deb Benko, WISH Conference Manager
733 15th St, NW, Second Floor
Washington DC 20005
Phone: 202-628-8669 ext. 108
Fax: 202-785-8576
E-mail: conference@now.org