I will be bringing child(ren):

Number of Child(ren):
Names & Ages of Child(ren):

I need special accomodations

Please specify needed accomodations here

Meal Preference:

Omnivore    Vegetarian

Get Involved:

I am interested in leading a workshop or discussion at this event.   

List details of workshop/discussion here.

I would like to donate an item for the raffle.   

List details of raffle item here.

Payment Method:
I will send a check, payable to "IPAN"
I will submit payment via Paypal Secure online Payment

Registration Sliding Scale - please choose the price you can afford to pay:
$30.00
$40.00
$50.00

The lower end of the sliding scale represents the costs of food, materials and space rental - if you are able to pay more, your generosity will help pay the way for someone with financial restraints at this point in their life. If you cannot afford the mimimum fee for the symposium, please email ipan@ipan.org to discuss alternatives - no one will be turned away for lack of funds.