INTERNATIONAL RATIONALIST CONFERENCE
8-12 February 2002: New Delhi, India

REGISTRATION FORM

Print this Registration Form and send the completed form along with your check favoring
"International Rationalist Conference" to:

Conference Secretariat
International Rationalist Conference
779, Pocket-5, Mayur Vihar-1,
New Delhi 110 091, India.

Name 
Street address 
  
City State 
Postal code Country 
Phone Fax 
E-mail E-mail (alternative) 

Payment Details
Mode of payment (tick the box) U S Dollars Sterling Pounds Euro Indian Rupees

Amount
Registration fee (US $ 150 or equivalent)                    

Optional events (Can be paid now or later - before 15 November 2001)

Get together dinner (9 February 2002) (US $ 30 or equivalent) 
Red Fort and Light and Sound show (11 February 2002) (US $ 30 or equivalent) 
Trip to Taj Mahal and Agra Fort (13 February 2002) (US $ 190 or equivalent)                    
Handicrafts festival (14 February 2002) (US $ 30 or equivalent) 

My donation for subsidizing delegates from developing countries                    

TOTAL                    

Check Number Bank 
 
Date Signature