Register by Thursday, March 18. Space is limited. Please complete one registration form per individual. The cost to attend is $20 per person, which includes breakfast and materials.
When you click "Submit," you will be given the opportunity to register another person or to pay with check /credit card. Once you have completed the payment, a confirmation page will appear. Please print the confirmation page for your records.
If you have questions or difficulties with the registration form, please call Jennifer Gray at 616-643-0117 or email jgray@graceoffice.org.
Ethnic Background:
Gender: Female Male
Have you attended an Institute for Healing Racism? Yes No
If yes, through which organization? GRACE Chamber of Commerce Woodrick Institute Other (please name):
Identify any special needs that we need to accommodate? Dietary (name): Handicap accessibility Other:
Are you willing to sponsor a High School student to attend the event for an additional $20? Yes No
Which organization, congregation, and/or business are you affiliated with?
When you press "Submit", you will be directed to our payment page. At that point, you can choose to register another person or pay through Pay-pal or by check.
After paying, press "click here to continue," and you will be directed to our confirmation page.
If you prefer not to pay by credit card, you are still registered to attend the Partners for a Racism-Free Community Annual Forum and will receive an automatic confirmation email. Payment must be made at the time of registration. Checks (made out to GRACE/PRFC Forum) need to be postmarked by March 18, 2010. If not received by March 19, please plan to pay at the registration table.
Send to GRACE 183 Lakeside Dr. NE Grand Rapids, MI 49503-3811. If you need help, contact us at 616-643-0117 or email jgray@graceoffice.org.
