Iranian Alliances Across Borders:
International Conference on the Iranian Diaspora
April 17-18, 2004 at Wellesley College and Tufts University
If you have any questions, please email us at:
iranianalliances@yahoo.com

Registration Form:
The registration fee: $15 students, $25 non-students, includes all of the transporation between the two
colleges and the breakfast and lunch costs for both days.   

**Either submit your payment by Paypal, or bring your check with
you Saturday morning (8:30am) at Wellesley College.
**Please note that registration is limited and is decided upon a first-come-first-serve basis.

The Fields with an '*' and that are in RED are required


Name*:                

Address*:  

Address #2:

City*: 

State*: 

Zip Code*: 

E-mail*:  

Insitution (if applicable): 

Profession: 

If Student, What Do You Study?: 

Do you have any dietary needs that we should know about? 
(ie: vegetarian, allergies, cannot eat certain types of meat, kosher, etc).  
Please specify

                                         
If you are a student, will you be requesting to stay in a dormitory with 
students in Boston? (Yes or No)*


 
                               

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