REGISTRATION FORM

Skeptic's Toolbox - Your Wonderful Brain
August 7-10, 2008
University of Oregon at Eugene
Eugene, Oregon

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WORKSHOP:

[ ]  Register [__________] person(s) at $169 per person (non-credited)

ACCOMMODATIONS:

[ ]  Reserve [__________] Single Room(s) and Board at $215 per person

[ ]  Reserve [__________] Double Room(s) and Board at $195 per person 

(Room and Board includes all meals and Saturday Banquet)

ADDITIONAL ITEMS:

[ ]  Register [__________] person(s) for Saturday Banquet at $30 per person 

[ ]  Register [__________] person(s) for Commuter Pass (all meals) at $80 per person 



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   Name: [____________________]

Address: [____________________]

   City: [____________________]

  State: [____________________]

    Zip: [____________________]

  Phone: [____________________]

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 Charge my: [ ] MasterCard,  [ ] Visa

 Account #: [______________________________]

Expiration: [______________________________]

 Signature: [______________________________]

 - OR -

[ ]  Check or Money Order enclosed


Make checks payable to CSICOP and mail to:

P.O. Box 703
Amherst, NY 14226-0703

(You can also register by calling 1-800-634-1610)

Contact Barry Karr for details at (716) 636-1425 ext. 217

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Registration(s) $[___________]

Accommodation(s) $[___________]

Additional Item(s) $[___________]
             
TOTAL $[___________]

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