• Check One: [ ] NOW Member [ ] Non-Member
• Registration fee postmarked before 1/20/98: $75.00
• Registration fee postmarked after 1/20/98: $85.00
• Those with income of $75,000+ are urged to pay $110 to enable others to register sliding scale $110.00
• Sliding scale fee: $35.00 - $74.00
• Total Amount: $________

Please Print:
Name_______________________________________________

Address_____________________________________________

City________________________State ______ Zip__________

Phone(____)_______________Email______________________
Yes, I Would Like To Volunteer: Fri__Sat__Sun__

Checks Payable to NOW - Charge to: Visa/MasterCard Only [ ]Visa [ ] MasterCard
Exp. date:_______________ Your Credit Card Number: _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _

Your Signature:_____________________________________

Special Needs: Summit facilities comply with A.D.A. requirements Specify: ___________________________________________________

• Child Care: Provided for attendees who register for it before 1/20/98. Please send me a child care registration form: [ ]
• Alternative Housing: Available first come/first served basis. I would like to receive information on alternative housing: [ ]
• Exhibitor Information: Send exhibitor/advertising rates: [ ]
• Summit Travel Agency: Reservations made through Gallery of Travel (800 837-3829) help us provide travel for speakers and guests. Be sure to say you are with the NOW Summit.
• Hotel Reservations: Call 1-800-445-8667 and mention the NOW Summit for special rates.

RETURN COMPLETED FORM WITH PAYMENT TO: NOW WOMEN OF COLOR AND ALLIES SUMMIT 1000 16TH STREET N.W. #700 WASHINGTON DC 20036

For additional hotel, volunteer, alternative housing, exhibitor, advertising, scholarship and sponsor information please contact Vanessa Salinas: 202-331-0066 ext. 771 or email: conference@now.org