The 12th Annual Conference
of the Caretakers of the Environment International

June 28th to July 5th, 1998

DELEGATE PERSONAL REGISTRATION FORM

Name

Gender (male or female)

School / Organisation

Delegate type (student or teacher)

Mailing address:

Telephone

Fax no.

e-mail

Theme group choices
(3 choices must be made in order of preference)
1st choice

2nd choice

3rd choice

Special dietary requirements (e.g. dietary, medical, disabled)
____________________________________________________________________________

Delegate signature

Delegation leader signature

Date