Symposium  Program  Speakers Registration

CONFERENCE REGISTRATION

Darwin, Design and Democracy II: Teaching the Evidence in Science Education
June 29 and 30, 2001
Registration is open to all interested persons.

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

You may also register online through iTickets.com with a valid credit card by clicking here.

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 fees.

Registration fee

Number x Amount = Amount Due
___  x  $30 = $____     Individual 
___  x  $50 = $____     Per Family (show names and family relationships  above) 
___  x $15 =  $____     Students and Science Teachers

Videos

___  x  $20 = $____     The Triumph of Design and the Demise of Darwin
___  x  $20 = $____     I was a Teenage Darwinist 
         Total = $____           

$__________ TOTAL ENCLOSED

Symposium  Program  Speakers Registration