Environmental Action 2010
Sunday, April 11, 2010

Bentley University, Waltham, MA

10:00 am- 5:30 pm
Mobilizing the Grassroots for a Greener New England

Cosponsor Registration Page

If you want to register as an individual, click here.

Cosponsor Attendee Information

Group Name

Attendee 1   Attendee 2
Name

  Name
Address   Address
     
City   City
State   State
Zip
  Zip
Phone   Phone
E-mail   Email

Additional Attendees ($20 Each)


Name

  Name
Address   Address
Want to mail in your registration form? Click here to download a printable versions!
     
City   City
State   State
Zip   Zip
Phone   Phone
E-mail   Email
Who did you hear about the conference from?

If you wish to register more than 3 attendees, please email their information sam@toxicsaction.org

   

Cosponsor Registration ($50 for 2 tickets)

Additional Attendees X $20 + $50 =

 

Tables: Cosponsoring organizations may rent table space to set up a display and/or distribute materials in the main hall. Space is limited, so you must register in advance. There will also be a communal table for all groups to leave materials for attendees to see.

½ table ($30 non-profit, $50 for-profit) Full Table ($60 non-profit, $100 for-profit)

 

Lunch: In addition to the complimentary breakfast and afternoon reception, we will be serving Boloco Burritos for lunch, which can be purchased for $5. To ensure we order enough, please indicate how many lunches you would like and what type(s) you would prefer.

Veggie    Chicken Beef

 

Insert Total Payment Here (registration + table cost + $5 each lunch if ordered)

Additional Information
Need childcare? Note: You must pre-register childcare so we can plan accordingly.
Yes / No
Number of children?
Ages?



 

  x

Payment Method:
Check     Credit Card

To pay by check: Select "Check,"click "Register," then mail your check to Toxics Action Center, 44 Winter St, 4th Floor, Boston, MA 02108. Please make the check payable to Toxics Action Center and write "Environmental Action 2010" in the memo line.

To pay by credit card: Select "Credit Card," click "Register" and enter your payment information on the next page. If you have any questions, please e-mail sam@toxicsaction.org or call (617) 747- 4362