1997 Public Policy Forum - Invisible No More! -Let Your Voice be Heard.  Make
Parkinson's A Priority In Washington.
July 13-July16, 1997  The Hotel Washington, Washington, DC
TO REGISTER:
Mail Checks and Registration forms to:

Parkinson's Action Network
818 College Ave., Suite C
Santa Rosa, CA 95404
fax 707-544-2363

Make checks payable to Parkinson's Action Network.  Please write "DC Forum"
in the memo section of your check.

Registration Fee:  $100.00


ATTENDANCE:



























                                                                          YES
                 NO
I will be attending the Forum.

Please indicate if this is your first PAN Forum.

I would like to share a room.

I will not be able to attend, but please send me a Forum packet.
(A $20. contribution is required for materials.)

I am being sponsored by the following Parkinson's support group:
 _______________

I will not be able to attend without financial assistance.
(There will be a limited amount of financial assistance available.)


SPACE IS LIMITED:
        If you plan to register on-site or after the advance registration, please
call PAN at 800-850-4726 to check on space availability.

BADGES:
Your badge will reflect the information you give us.  Please type or print,
 OR attach your business card.
Ms..........Mrs..........Mr..........Other..............
Name..........................................................................
.....................
         first                     middle                       last
Nickname......................................................................

Title................................................................
Organization................................................
Address.......................................................................
.....................
City............................................State.........................
Zip...............
Phone..................................................fax....................
......................

HOTEL ACCOMMODATIONS:
The Forum will be held at The Hotel Washington, 515 15th St., NW.
To reserve a room, call Washington DC Accommodations at 800-554-2220,
Monday-Friday 8:30-5:30 Eastern time.  Ask for a room reserved for the
Parkinson's Action Network.  The Network has arranged a special room rate of
$99/night (single or double occupancy) which includes breakfast in the hotel
restaurant.

I am making my own room reservations.         yes.....................
      no...................

I would like to share a room.
Please call me to make these arrangements.   yes....................
      no...................

Please indicate any special requirements (physical, dietary,
etc.).........................................................................
.......................

Parkinson's Action Network
800-850-4726
fax 707-544-2363
email   [log in to unmask]
Washington DC office 202-628-2079
Brad Udall, Chair
Joan I. Samuelson, President
John L. Dodge, Treasurer
Michael Claeys, Community Coordinator