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Conference Registration Form

* Required Fields

Please submit one form per registrant. (Note: each registrant must be approved by her home institution's office of the president/principal, or by conference organizers.) Registration deadline is May 15, 2008.

Demographic information

1	Name: *
2	Title (for college advisors):
3	Year of expected graduation (for students):
4	Institution: *
5	Name for badge (Preferred first name): *
6	Street address 1: *
7	Street address 2:
8	Street address 3:
9	City or province: *
10	State: *	outside of US:
11	Zip or postal code: *
12	Phone with Country Code: *
13	Fax:
14	Email: *

Conference Details

1. Dietary Needs

Low fat	Vegetarian	Kosher
Shellfish	Allergy	Vegan
Other:

2. Special Needs

	Yes, I require special arrangements and/or I have questions about physical access. Please follow up with me.
	No special needs.

3. How did you hear about this event?

	Invitation		WEW member college		Web site
	Other:

Giving Back Project

1. 50-word description of Giving Back Project : Participants are asked to choose in advance a project to work on in their community upon their return from the conference. This project should be an active program intended to better a community. The conference will empower students to see themselves as agents of positive change, and the workshops will offer skills to support planning and achieving project goals.

2. Please check all that apply:

	On-campus project
	Off-campus project
	Independent project work
	Group project work
	Project for my school
	Project for the community
	Project about policies
	Project about a program
	Project about structure
	Project about campus policies
	Project to create a social or education program
	Project to enhance a student government structure or other student organization
	Other

Language:
Please estimate your English language proficiency:

Native/Bilingual Proficiency
Strong proficiency
Intermediate/working proficiency
Limited/conversational proficiency
Basic proficiency

Travel:

1. Arrival Info:

I will submit my travel information later (to Winnie Rivera Vallejo).

Airport
Airline
Flight #
Date
Time

2. Departure Info:

Airport
Airline
Flight #
Date
Time

3. All participants using Bradley International Airport in Hartford are guaranteed ground transportation to and from the conference. Limited bus service to and from the airports in New York City and Boston will also be available. Please note that riders may be required to wait at the airport while other participants arrive. Are you interested in this service?

Yes

Payment *

The registration fee is $250 (US) per person.

	I will send my registration fee via check (US participants only). Please send to: Office of the President, 50 College St., South Hadley, MA 01075
	I will wire my registration fee (US and International participants). Be sure to include your name and purpose of payment --"WEW Conference"-- on the wire.

Note: if you do not receive email confirmation of your registration within 7 days of your submission, please email Winnie Rivera Vallejo.