Intelligent Design network, inc. Darwin, Design and Democracy V: Science Converges on Design ADVANCE CONFERENCE REGISTRATION FORM

Registration is open to all interested persons.  

To register and purchase tickets with a credit card (at no additional charge)  click here.

To register by check or money order, please print out this form.  Then mail it with your check or money order made payable
to Intelligent Design network, inc. to:  Intelligent Design network, inc. •  P.O. Box 14702  • Shawnee Mission, Kansas 66285-4702

Please Print Clearly:

Name - First Registrant:__________________________________________________________________________________
Name(s) - Other Registrants_______________________________________________________________________________
____________________________________________________________________________________________________
Address _____________________________________________________________________________________________
____________________________________________________________________________________________________
Phone_______________________________________________________________________________________________
E-mail_______________________________________________________________________________________________
Fax_________________________________________________________________________________________________

Please enclose a check or money order made payable to Intelligent Design network, inc. for the appropriate amount. 
Complete the following to calculate the amount to enclose with this registration form: 

Number x Amount = Amount Due
___  x  $40 = $____     All Events - Individual 
___  x  $60 = $____     All Events - Per Family*
___  x  $20 =  $____     All Events - Students and Science Teachers
___  x  $15 = $____     Saturday evening only (Michael Behe and Jeffrey Schwartz)
___  x  $ 8 =  $____     Box Lunch**
___  x  $15 =  $____     Saturday evening buffet dinner**

___  x  $20 = $____     Unlocking the Mysteries of Life
___  x  $20 = $____     Icons of Evolution
___  x  $20 = $____     The Triumph of Design and the Demise of Darwin
___  x  $20 = $____     I was a Teenage Darwinist 
         Total = $____     Videos will be delivered with your conference registration packet when you arrive:      

           $__________    TOTAL ENCLOSED

To obtain a confirmation please include an email address above.  Registration packets and badges will be provided at the door.
*    The family rate is designed to be budget friendly to a single household.  Hence we define family as spouses, parents, and children living together.  
**    We will not be selling lunch or dinner tickets at the door.  If you do not purchase a box lunch or dinner in advance you will need to make your own arrangements for meals.