ISIN - Registration for Toronto Pre-Meeting Workshop ONLY
March 13, 2003
Registration Form for Credit Card Payment

Please note: REGISTRATION DEADLINE IS FRIDAY, FEBRUARY 21, 2003. Enter contact information as you would like it to appear on the workshop attendee list. Name _________________________________________________________________________ Organization _________________________________________________________________ Mailing Address ______________________________________________________________ ______________________________________________________________________________ City, State, Zip/Postal Code _________________________________________________ Country ____________________________ Email ___________________________________ Phone _________________________________ Fax __________________________________ ........................................................................................ I will attend the following workshop: ____ Workshop 1: From Community Indicators to Community Sustainability - Embedding Indicators in Community Improvement Efforts. ____ Workshop 2: Seven Questions to Sustainability. Special dietary or other needs: _____________________________________________________ ........................................................................................... Please note: Credit card payments will be processed in US$ and will use the exchange rate determined by the credit card company on the date of the transaction. Only Visa or Mastercard are accepted. I have enclosed payment for the following: Workshop 1: US$75 ISIN Member ____ US$175 Non-Member ____ Workshop 2: US$130 ____ TOTAL PAYMENT (US$): $________ Credit card type: ____ MC ____ VISA Credit card number: __________________________________ Expiration date: _____/_____ Billing information must be entered EXACTLY as it appears on the credit card statement (if different from information provided above). Name:________________________________________________________________________________ Address:_____________________________________________________________________________ City, State, Zip/Postal Code:________________________________________________________ _____________________________________________________________________________________ .................................................................................... Please return your completed registration form by fax to (978) 975-1934, or by mail to ISIN, Attn: March Workshop Registration, P.O. Box 361, North Andover, MA 01845. Cancellation Policy : US$25 fee for cancelling before Friday, Febuary 21, 2003. After February 21, registration fee not refundable.