International Child Art Foundation
2003 Awards Ceremony

REGISTRATION FORM
First Name
(as it will appear
on your name badge) 		Last Name

Title

Company / Organization

Address

City State Zip

Telephone Fax

E-mail Address

Registration Fee - Check all applicable boxes.

Individual Ticket $150
 Country Table $1500
I would like to make a contribution to support the work of
     the International Child Art Foundation. 		     Amount $________


Total remitted $______________

Accepted Methods of Payment:
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Credit Card Number: Expiration Date:

Cardholder's Name:
(as it appears on card)

Signature:

Mail
Credit card or check payable to ICAF Awards Ceremony
Mail to: Louisette Hunter - Awards Ceremony
International Child Art Foundation
1350 Connecticut Avenue, NW
Washington, DC 20036-1702 		Fax
Credit card payment only
(202) 530-1080