Ethnic Studies Conference Registration Form

OCT 1-2, 2010

SAN DIEGO MESA COLLEGE

Sponsor: San Diego Ethnic Studies Consortium

E-mail: sdethnicstudies@gmail.com

Tel:619-388-2375

Fax: 619-388-2677

Attention: Manuel Velez, Chicano Studies G-103C

Name *

Title *

Institution/Organization/Affiliation *

Address *

City/State/Zip Code *

E-mail *

Telephone

Would you like to be added to the Ethnic Studies Consortium listserv?

(This listserv will only be used to disseminate information about Consortium activities, events hosted by its affiliates and contemporary issues related to Ethnic Studies.)

Yes

Suggested Donation

There is a suggested donation of $10 for Faculty and $5 for Students and Community to help us cover the costs of this event. However, this is not a required registration fee and no one will be turned away due to lack of funds.

Unfortunately, we cannot accept credit or debit cards for these donations. We will accept cash, money orders, cashier's checks, or personal checks. These can be handed in at the Registration Desk on the day of the event.

All checks must be made out to: SDMC Ethnic Studies Conference.

How many people will be attending?

	Faculty -- $10
	Students -- $5
	Community -- $5

Other amount you wish to donate

If possible, please print out and bring this registration form with you when you check-in at the Conference Registration Desk.

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