Pre-Registration

First name:
Last name:
Address:
City:
State
Zip Code:	Email:
Phone:	Fax:
I am an MIC Member: Yes No
Please pre-register me for:
For Luncheon Programs Only -- Check One:
I will attend the Full Program. I will attend the Program Only.
For the Annual Symposium Only (Held in June) -- Check One:
I will attend the Full Program. I will attend the Lunch Only. I am a Student and will attend the Program Only.
Registration is not complete until payment has been made by check or credit card. Please contact MIC at the following address regarding payment information. MIC regrets that you will be charged for cancellations made less than two full business days in advance of programs, or cancellations made after the registration deadline, if one is given. Minnesota International Center 711 East River Road Mpls, MN 55455 Fax: (612) 624-1984 Phone: (612) 625-4421