Families on the Fault Lines: Conference Registration Form

Please register for the Families on the Fault Lines conference by April 23rd.

Name: *

Title / First Name / Last Name

School, Department, and/or Organization:

e.g. University of California, Berkeley, Ethnic Studies /or UNICEF

Email Address: *

Put your email address here

Date(s) of Attendance: *

Thur, Apr 29th: Families on the Fault Lines Conference (9 am to 4 pm)

Thur, Apr 29th: Cathy Cohen, Keynote Lecture (5:30 pm - 7:30 pm)

Fri, Apr 30th: Families on the Fault Lines Conference (9 am - 2 pm)

You may select more than one option

Mailing Address:

Address you would like communications mailed to.

Would you like to be added to our mailing list?: *

Yes, I would like to receive emails about CRG events.

No, please do not add me to your mailing list.

Thank you for registering.
For questions, please contact us at
familiesonthefaultlines@gmail.com.

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