Interface Online Registration

2008-09 Interface Online Registration

To attend Interface, simply sign up to become a member by filling out the registration form below:

First Name:

Last Name:

Credential:

Affiliation/Title:

Address:

Apt./Suite:

City:

State:

Zip:

Phone(w):

Phone(h):

Phone(c):

E-mail me a monthly program reminder to me at:

E-mail:

Do not send related information from other organizations.

Annual Membership: $79.00
	Covers all 11 Wednesday morning programs, including continental breakfasts (a $20 savings; $9.00 per session at the door).
Payment Options:
	I will pay $79.00 online with my credit card using Paypal.
		(After clicking "submit" you will have the option to make a secure payment with Paypal)
	I will mail a check today for $79.00.
		(Print out this page & enclose your $79 check. Make checks payable to "INTERFACE" & mail to: Interface; PO Box 17474; Boulder CO 80308)
	I plan on attending, but will pay $9.00 at the door.

Comments/Suggestions:

INTERFACE respects the privacy of members, attendees, presenters and contacts. Interface never sells it's mailing list to anyone. Contact information is used to inform about Interface activities, and occasionally for related announcements deemed of special interest to the Interface community. Email or snail mail addresses may be shared with organizations that co-sponsor an Interface event. Any individual may request their contact information be restricted to Interface announcements only, or that their information be removed completely, by sending an email request to.