Ready to Run™ Iowa – April 3, 2009
On-line Credit Card Registration Form

Registration fee: $75 on or before March 28. $100 after March 28. Fee includes all sessions and training materials; breakfast, lunch and afternoon refreshments; workshop notebook; and campaign training manual.

 

Your registration is not final until your registration fee is received.

 
Track 1: I’m Ready to Run, Now What?
 Track 2: I’m Not Ready to Run Yet, But…  

Name

First*

Middle

Last*

Title:


 

Organization:


 

Address*:

home      office    (check one)

 

 

City*

State*

Zip*

Home Phone*: 

Office Phone: 

  Fax: 

Email*: 



















Vegetarian Meal Preferred :  

Party Affiliation (optional):

I am planning to run for office in the near future: 
If yes, which office   

How did you hear about the Ready to Run ™ Iowa program?

 

Please check if you would like to apply for a scholarship:


  Travel Scholarship (list roundtrip mileage to and from Ames and hotel expenses, if you need to stay overnight due to travel).

         Mileage:                Hotel:

     
  Registration Subsidy of  (request amount)
        Amount:     You will need to pay the full tuition. If you are awarded a registration subsidy, that amount will be refunded to you following the conference.

 

Your credit card will be charged the full tuition amount. If you are awarded a registration subsidy, that amount will be refunded to you following the conference.


* Required information

QUESTIONS?
PLEASE CONTACT THE
CARRIE CHAPMAN CATT CENTER FOR WOMEN AND POLITICS
309 CATT HALL
IOWA STATE UNIVERSITY
AMES, IOWA 50011-1305
PHONE: 515-294-3181
EMAIL: CATTCNTR@IASTATE.EDU