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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