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Registration Form

MONTREAL INTERNATIONAL WOMEN’S CONFERENCE 2010

August 13-16 2010, Montreal, QC, Canada

Theme: For a Global Militant Women’s Movement in the 21st Century! Celebrating the Centennial of International Women’s Day

Please print, email to wdofdo@gmail.com, or mail the form below (see address below).

Or

REGISTER ONLINE!

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Registration Form

  1. Name of participant: ____________
  2. Nationality:_______________
  3. Name of your organization (including acronym): _________
  4. Address: ____________
Phone: ______________

Fax: ______________

Mobile: _____________

E-mail: _____________

  1. Type of Organization:

__ Women’s Organization

__ Non-Government Organization,

please specify what sector_______

__ Sectoral organization/Alliance/Federation,

please specify______

__ Others,

please specify __________

  1. Themes/Topics your organization is concerned with:
Workshop topics you are interested to participate in (please refer to program for list of workshop topics):

  1. Scope of Organization:

_ International

_ Regional

_ National

Others (pls. specify) _____

  1. Is your organization a member of a local, national, regional or international network or coalition?

Which one(s)? _______________

  1. Are you being sent by your organization to participate? Yes No
  2. Other information (for accommodation purposes):

10.1 Food preference: _______________

10.2 Medical considerations (if any): ____________

10.3 Other considerations (please specify): __________

11. Do your delegates need a letter of invitation for securing a visa to Canada?

Yes No

You can access the information on countries needing visa for Canada at:

http://www.cic.gc.ca/english/visit/visas.asp

Completed by: __________

Date: _____________________

______________________________________________________
(Print name and sign)

The conference will take place at the Le 7400, at 7400 boul. St-Laurent (Métro de Castelnau).

Lodging for out-of-town participants is available in comfortable rooms at the site of the conference, Le 7400.

Full Registration: (conference fee, lunch and accommodation for 3 nights): CND$350

Registration (no accomodation): (conference fee and lunch) $150

Plenary day only: $50

– ** Group Rate: — Full Registration: (conference fee, lunch and accommodation for 3 nights): CND$275 per person for a group of 5 or more

Payment methods:

Complete this form and return by e-mail to: wdofdo@gmail.com

Or mail to:

Montreal International Women’s Conference 2010 – Secretariat

c/o 4755 Van Horne, Suite 110, Montréal, Québec H3W 1H8 Canada