Heartland Men's Conference 2000

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Second Heartland Men's Conference
Registration Form

November 11, 12, 2000
Pre-Conference Event with John Lee: November 10
Robert Bly
Poetry Reading at MU November 11

Ramada Inn Conference Center
Columbia, MO


Fees (check those that apply)

Conference Fee (Nov. 11-12)

$199.00

Pre-Conference Fee with John Lee (Nov. 10)

$30.00

Robert Bly Poetry Reading @ MU

$15.00

Robert Bly Poetry Reading with Conference Registration

$10.00

Early Conference Fee postmark by Nov. 1

$175.00

Early Conference Fee for 2-postmark Nov. 1

$340.00

Group Rate (6 or more registrants)-per person fee)-Must be sent together and postmarked by Nov. 1, 2000

$165.00

Senior Rate (60 and over) ........Age: ______

$165.00

Full-time Student
School: _______________________

$165.00

Saturday Only

$120.00

Sunday Only

$110.00

Certificate of Attendance

$2.00

Total Enclosed

$ ________

 

Payment method: Check or Money Order payable to:

Patrick Kane - The Heartland Men's Conference


To register, please return this form with proper fees to:

 

Heartland Men's Conference
c/o Patrick Kane
2100 E. Broadway, Suite 213
Columbia, MO 65201


 

Name: __________________________________________

Address: ________________________________________

City: _____________________ State: ___ Zip: __________

Phone: (______)________-_________________



Register Early: Attendance limited to 350 men/women.

Jeff Belden, webmaster
JeffBelden@home.com
Date Last Modified: 11/5/2000

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