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