Conference Registration
 
Please return as soon as possible to the address below.
If you need additional information, contact our office at 623-7576. Thank you!
 
 
Name
 
Organization/Agency
 
Address
 
City
 
State
 
ZIP
 
 
Telephone
 
E-mail
  Are you a Woman Unlimited graduate?



  If so, please state the program(s) and your graduation year(s)
 

March 19th Dinner sponsored by Board of Directors:
Open registration - $40
* Reduced registration - $25

 

March 20th Conference:
Registration at $59
(includes meals and workshops)
 

March 20th Conference:
Late registration fee (for registrations received after March 12th
 
Yes! I want to partially or fully fund a scholarship in the amount of:
 
Total due:
  * Reduced registrations available for all Women Unlimited clients (past or current)
and for Tradeswomen with a small business with fewer than five employees.

(make checks payable to Women Unlimited)

Name On Card:
Credit Card Number: (no spaces)
Card Type:
Expiration Date:
CID (3 digits from back of card):

Please print this form, drop it by our office, or mail or fax to:

MTN Conference
103 Winthrop Street
Augusta ME 04330

(207) 623-7299