Wufoo

VWHE 2009 Spring Leadership Dinner

To register for the VWHE Spring Leadership Dinner, please fill out and submit the form below. The cost of the dinner is $35 and can be paid online via PayPal or by sending a check to the address below.

Name * First Last
Title
Institution
Email *
Work Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Work Phone ### - ### - ####
Payment

The cost of the dinner is $35. You may pay online by clicking the PayPal icon on the confirmation page after registering

- or -

by sending a $35 check made out to Vermont Women in Higher Education to:

Tammie Consejo
Champlain College
PO Box 670
Freeman Hall Box 34
Burlington, VT 05402
Please select your payment method:
Do Not Fill This Out

Wufoo

VWHE 2009 Spring Leadership Dinner

Payment