GLI2FCA Twelve
To register for the meeting, please fill out and mail this form by 9/12/03 with payment to:

GLIIFCA Office
c/o Julie Auger.
University of Chicago
910 E. 58th St. Room 007
Chicago, IL. 60637
For info. call (773) 702-9261 or FAX: (773) 702-7195
email: jauger@uchicago.edu

Name:                                                                                    

Mailing Address:                                                                  

City:                                                                                        

State/Province:                               Zip:                        

phone:                                       FAX:                                  

email:                                                                                    

Affiliation:                                                                              

Make checks payable to GLIIFCA.
__ $70.00 US (includes membership) (no credit cards)
      Fee at meeting will be $85.00 US
__ will attend the reception on Fri. evening (free w/reg.)
__ will attend the Sat. Eve. Banquet (free w/reg.)
__ banquet guests: $25.00 US for each.

If you wish confirmation of your registration, please enter an email address above.