M S A Y A L E

Muslim Students' Association - Yale University

Registration Form

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Name:

Organization/School:

Title (if any):

Address:

City:

State:

Zip Code:

Phone Number (include area code):

E-mail Address:

(Optional) Please include with your registration an answer to the following question: What do you view as the most immediate concern to be addressed among the rising generation of American Muslims - both within and outside of the community. Please limit your answer to 250 words.

Fee: $20 pre-registration (checks will be received if postmarked by April 10th), $30 onsite

Make checks payable to:
Yale Muslim Students Association
P.O. Box 202217
New Haven, CT 06520

I am paying for the registration of myself and other person(s). (For each add'l person, add $20 (mail/PayPal) or $30 onsite for that person)

I will mail in a check for the conference registration fee of $20 by April 10, 2002.
I will pay the onsite conference registration fee of $30 when I arrive on the day of the conference.
I will pay the $20 fee using a credit card via secure, fast PayPal (To pay with PayPal, first complete this form and click REGISTER below).

I will be using a car to to get to the conference.

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