IRELAND AND GENDER Glucksman Ireland House NYU March 1-3, 2007

							                                IRELAND AND GENDER
                        Glucksman Ireland House NYU March 1-3, 2007
                               Conference Registration Form

                                Registration Fee: $40
               Members of Glucksman Ireland House Registration Fee: $25
(includes light breakfast and buffet lunch on Friday, March 2nd and Saturday, March 3rd in Glucksman Ireland House)

       Personal Details

       Name:____________________________________

       Affiliation:_________________________________

       Address:___________________________________

       City:_______________________________________

       State:_________________          Zip:_______________

          I am a Member of Glucksman Ireland House

          Payment by check: please make check payable to: Ireland House NYU/GRIAN

          Payment by credit card

       Name on Card:__________________________________

       Card Number:___________________________________

       Card Type: VISA/MC/AMEX (please circle one)

       Amount: $_________ Expiration date:_______________

       Signature:_______________________________________

       Zip Code of Billing Address___________ Telephone: ________________________

                                  Please mail this completed form to:
                              GRIAN 2007, Glucksman Ireland House NYU
                              One Washington Mews, New York NY 10003

                               http://irelandhouse.fas.nyu.edu/page/grian

                Note: NYU students may opt to attend conference sessions without charge,
                    but are ineligible for breakfast or lunch unless registration is paid.