Name and Address Information Print carefully. Your badge will be printed with the information below Last Name: First Name: Middle: Prefix: Company/Agency/Self: Address: City: State: Zip-Code: African Country if applicable: E-mail: Daytime Phone: Fax: Disability Accommodation Required: Check all that apply.  Dinner banquet must be reserved; this information assists in conference planning and dinner preparation. I plan to attend:    Conference Only - Free (Internet or fax registration by November 12, 2003 or $15 logistics cost thereafter.  Conference and Soccer Championship game $7  Conference and Movie $7  Conference and Dinner $25 Conference and Dance $20 FULL PACKAGE  Conference  Kwame Nkrumah Nationalist Football (Soccer) Championship  Movie   Solidarity Dinner  Solidarity Ballroom Dance Individual registration $30 per person (with paid registration by November 10 or $40 per person thereafter Sunday Cocktail - Meet and Greet Odumegwu Ojukwu on Sunday, November 16, 2003 from 4:00 PM to 7:30 PM.  By invitation Only - $75 per person.  Call, e-mail or fax information for an invitation card. _____________________________________________________ Make checks payable to: The Africa Solidarity Council, Inc. P.O. Box 77352, Washington, D.C. 20013   ASC, Inc.’s Federal Tax ID number is: 52-2089954 Three Easy Ways to Register Prior to November 10, 2003: 1. Mail your form and payment to: The ASC, Inc. P.O. Box 77352, Washington, D.C.  20013. 2. Fax your form only to: the ASC, Inc., 301-773-1663.  Attach a statement promising payment upon arrival.  Without this statement your registration will not be processed for the ticketed events. 3. Print your registration form from the internet. For further information, contact Conference Planning Committee at 202-387-8049, 301-773-2443.  Or on Internet at: www.africasolidaritycouncil@asconline.org.

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