MIUSA 2018 Gender, Disability, and Development Institute

Thank you for your interest in participating in GDDI! This event is by invitation only. If you received an invitation from MIUSA to register, please fill out the form below and submit the requested payment. If you did not receive an invitation, please do not register or submit any payment. For questions, contact Suz Dunn at sdunn@miusa.org or (541) 343-1284 ext.17.

Institute Date: Monday May 28, 2018

1. First name *This question is required.

2. Last name *This question is required.

3. Will someone be attending on your behalf if you are unable to attend? If so, please indicate the person's name here.

4. Organization *This question is required.

5. Title/Position *This question is required.

6. Email *This question is required.

7. Address *This question is required.

8. City *This question is required.

9. State or Country *This question is required.

10. Zip Code

11. Telephone/TTY

12. Fax

Section 2: Disability Accommodations

13. Please indicate if you will need any disability-related accommodations or services to participate fully in this Institute or the formats of materials you prefer for the agenda, schedule, and take-home materials.

Section 3: Dietary Requests

14. Please indicate if you have any dietary restrictions or preferences.

Section 4: Registration Fee and Payment information

Deadline for $125 early bird rate: Friday, April 6, 2018
Deadline for $150 regular rate: Monday, May 7, 2018

15. Payment: Please check one box to indicate how you will submit the registration fee *This question is required.

Online payment by credit card (use link provided on 2018 web page)
Call MIUSA at +1(541) 343-1284 to pay with a credit card (Visa, Mastercard, or Discover only)
Email MIUSA at sdunn@miusa.org about my financial reasons for a reduced rate

Section 5: Additional Information

16. Please share why you are interested in GDDI, how you learned about it, or other comments or questions.

17. Biography: Please submit your professional bio. Include a brief description of your role in your organization, your expertise, your organization's geographic focus, or any experience you have working in gender and/or disability issues (250 words max.) *This question is required.