[Please copy this registration form into an email and send the 
completed form to decolonization@riseup.net ]

Land, Decolonization and Self Determination
Workshops, Conferences and Films
May 13-15th 2005

PRE REGISTRATION FORM
Name:
Organisation/Affiliation:
When do you plan to attend? 	May 13th/May 14th/May 15th

Do you need childcare?
For how many children?
What are their ages?
Time childcare is needed:

Lunch will be served on Saturday and Sunday. Do you have any food
allergies or restrictions that we should be aware of?

Do you need translation?	French to English/English to French//Other:

Billeting
Do you need housing? If so, which nights?
Sleeping Needs (i.e. floor, couch, bed):
Allergies?
Accessibility Needs?

Would you like to set up an information table? If so, please contact
decolonization@riseup.net or 514-398-7432

Do you have any other concerns?


Contact Information
E-mail:
Phone number:
Phone number (2):
Address:

Would you like to join the IPSM electronic mailing list?