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Registration Form

Send your Registration Form to:

Laura Gobbi, Director of Alumnae Relations
Office of Institutional Development
Mills College
5000 MacArthur Blvd
Oakland , CA 94613-1301

Fax: 510.430.3383
Phone: 510.430.2112

Make your check out to: Mills College or pay by credit card from the registration page

Full Name: ______________________________________________

Tag Name: ______________________________________________

Title: ___________________________________________________

Institution: _________________________________ Public ___ or Private ___

Mailing Address: __________________________________________

City: _________________ State: _______ Zip Code: _____________

Telephone: ________________________ Fax: __________________

Email: __________________________________

Web Address: _____________________________________

Is this your first time at Minary? Yes___ No ___. If No, how many times have you attended? _____

How long have you worked in alumni relations or alumni education? _____ years

Describe your responsibilities. ________________________________________

To whom does your office report? ______________________________

Size of your program: ___Small Shop (1-3 FTE)  ___Med (4-15 FTE)  ___ Large (16+ FTE)

[FTE=Fill Time Equivalent. i.e. 3 staff working 1/2 their time on alumni education = 1.5 FTE]

# of Addressable Alumni _____________

# of Undergraduate Students ___________      # of Graduate Students __________

Will you be bringing a guest? Yes___ No ___. Name of guest: _________________ [Fee for a guest sharing same accommodations is $400; fee includes accommodations and meals]

Fee: $800 before or on September 4 ($850 after Sept. 4)      Total Enclosed: $____________

[Fee includes conference, materials, accommodations, and meals] Made payable to Mills College