Df 19Reg — Project Renaissance

REGISTRATION FORM
(Please check all applicable events)
◆ Beyond-Einstein Training, Thursday-Friday, May 19-20, 2011—$295
◆ Double Festival 2010 Conference, Fri./Sat./Sun., May 20-22, 2011—$495
◆ Beyond-Einstein plus Double Festival, May 19-22, 2011—$590 (save $200)
◆ Trainer Training, May 21-23, 2011—$100 a day
◆ All 3 events together ($1090 value) — $795 before April 15, 2011 (save $295)
◆ Students, Teachers, first two events together —deduct an additional $75
◆ Family Plan—accompanying spouses and responsible family members, half price
◆ Alumni discount for previous attendees—an additional 15% off any event
◆ Military discount for veterans — 10% off any event

Name_____________________________________________________________

Phone _________________________________

Email/URL_________________________________________________________

Address___________________________________________________________

City___________________________________State______ ZIP______________

Your field or profession____________________________________________

◆ Check/money order payable to Project Renaissance (in U.S. dollars), or:

◆ Mastercard/Visa number_______________________________

Exp. date_____________ Amount___________________

Signature________________________________Date_____________________

Optional: — Do you have special needs for which you would like accommodations provided at the Festival, and/or what would you like for us to know about you? (Use back of sheet if more space is needed.)

Print out, fill out and mail with payment to:
Project Renaissance, P.O. Box 332, Gaithersburg, MD 20884-0332