Preserving the American Dream Conference Registration Form

Fill out this registration form to reserve space for the Preserving the American Dream conference.

• Standard rate ($175)
  
• Student/low-income rate ($145)
  

I would like to attend the April 15 workshop ($25).

I would also like to go on the option tour of Portland-area smart-growth projects ($25 - must register for either conference or workshop).

I plan to attend the Friday evening discussion featuring Rep. Earl Blumenauer, John Charles, and Andy Kerr (free if you are attending the conference or workshop, $10 for everyone else).

I would also like to join the American Dream Coalition ($25) and contribute $ .

I will pay by Check or by PayPal.
If by check, make checks payable to "American Dream Coalition" and send to:
ADC, P. O. Box 1590, Bandon, OR 97411.
If by PayPal, direct payment to american@americandreamcoalition.org.

We will reserve space for you when we receive payment. If you must cancel before April 1, we will give you a full refund. If you must cancel after April 1, your refund will depend on whether we can fill your space with a late registrant.

Name:
Organization (if any):
Address:
City: State: Zip:
Phone: Email:

Please contact me about possibly becoming a conference co-sponsor.

I also have the following comments or suggestions: