2008 Civil Liberties and Public Policy Conference Registration

Your Information
First Name:
Last Name:
Email:
Phone: Format: XXX-XXX-XXXX
Permanent Address
Street:
City:
State:
Zip:
Country:
Demographics
Date of Birth: Year: Month: Day:
Gender:
Ethnic / Racial Background:
Current occupation:
Organization:
Current Student?:
School:
2008 Conference Information
CLPP Program Evaluation
How many times have you attended the conference?
How did you hear about the conference?
Please specify:
Housing (optional)
The deadline for registering for free housing was March 21st. Please contact us if you need more information.
I need housing for: Friday Saturday
Emergency contact name: Required if you request housing.
Emergency contact phone: XXX-XXX-XXXX Required if you request housing.
Group me with people from:
Group me with the following people:
Group name:
Sign Language and Child Care (optional)
The deadline to request interpretation is March 3rd.
I need sign language interpretation:
If you require other accommodations to ensure access to all programs during the conference, please indicate what your needs are as soon as possible.
The deadline to request child care has past!
I need child care: Friday Saturday Sunday
Age of child:
Mailing Lists (optional)
Sign up for: CLPP Postal Mail List
POP/DEV Postal Mail List
CLPP Email List
POP/DEV Email List