REGISTRATION FORM
Complete registration forms must be received by April 6, 2007. Registrations will
only be accepted with full payment. We reserve the right to return forms after capacity
has been reached. Written cancellations received by April 6, 2007 will be honored
with a full refund, less a $50.00 processing fee. Complete a separate registration form
for each participant. Mail completed registration form to Janice Johnson, Gallaudet
University, Student Academic Center - Room 2237, 800 Florida Avenue NE,
Washington, DC 20002-3695. Please print or type.
Mr. -Ms.-Dr.-etc.: ____________________________________________________________
Last Name: ____________________________ First Name: ___________________________
Title: __________________________ Organization: _________________________________
Address: ____________________________________________________________________
City/State/Zip Code: __________________________________________________________
Province: ____________________________ Country: _______________________________
Telephone: ___________________________ Fax: ___________________________________
E-mail: _____________________________________________________________________
COMMUNICATION AND SPECIAL NEEDS
Preferred Communication Mode: American Sign Language English
International Sign Language West African Sign Language
South African Sign Language
Close Vision/Tactile Interpreting: Yes No
Wheelchair Access:
Vegetarian: Dietary Restrictions:______________________________________
REGISTRATION FEE (includes 1st day breakfast, lunch and reception, 2nd daybreakfast, lunch and dinner, 3rd day breakfast and lunch)
International Registrant $100
U.S. Registrant $350
Student $100
Late Registration Fee add $50 (registrations received/postmarked after April 6, 2007)
All payments must be in US$ (US Dollars) in the form of cash, money order, cashier’s check,
or certified check made payable to Gallaudet University. Send registration form and payment
to Gallaudet University, Student Academic Center, Room 2237, 800 Florida Avenue, N.E.
Washington, D.C. 20002-3695, U.S.A., and Attn: Ms. Janice Johnson or you may register at
the Website, deafafricanwomen.org, and send the payment to the above address.
HOTEL INFORMATION
The conference has reserved a block of rooms at the ESKOM Convention Centre, Dale
Road, Midrand, Johannesburg, South Africa. Participants are invited to reserve rooms at the
special daily rate of:
Double Deluxe (one double bed) R 503.88 or $63.60 (US Dollars)
Single Deluxe (one single bed) R 450.30 or $56.95 (US Dollars)
Standard R 385.32 or $48.63 (US Dollars)
To lock in this price, contact the hotel directly.
Scholarships for acccommodations and registration fees are available. If you are interested or
need a scholarship, please complete the enclosed form.
Download: ConferenceRegistration (PDF, 2,585 KB)
