Special Payment Plan

Please print the form below and mail or fax the information to us.

Please include the Full Registration Form and/or Hotel Preference Form.

INTERNATIONAL FOSTER CARE ORGANIZATION

IFCO 2005 Conference - Payment Plan

We have developed a payment plan program to help ease the burden of paying for the conference in one payment. You can make small monthly payments and divide the payments over an 18-20 month plan. Agencies can pay by purchase order.

Name: _______________________________________________________________________

Address: ________________________________________________________________________

Country: ____________________________ Code: ______________________________________

Telephone: ________________________________ FAX: __________________________________

Email Address: ______________________________________________

Please indicate by Ö the items below you’d like to include in your payment plan.
(Each fee is per person)

___ Adult Full Conference Registration Fee: $450.

Please indicate: __ Foster Carer __ Social Worker __ Administrator __ Other ________________

___ IFCO Member (send copy of membership Card) $400.

___Accompanied Person: $250. Name: ___________________________________

___Youth Registration: (Age 13 - 24) $250. Date of Birth: _____________________________

___Child Care: (Age 5-12) $250.

Names: ________________________ _____________________ ______________________

___HOTEL: Indicate Choice: _______________________________________

____ Indicate if you want a portion of your payment plan to include Lodging.

Full payment will be refunded for cancellations made in writing before May 1, 2005. Otherwise, all sales are final!

Account Numbers will be set up for each Individual Payment Plan. Each payment must include your full name, complete address and account number.

We suggest you keep a copy of your check until confirmation of receipt is made by us or until the conference date. Payments can be mailed in at any time by U.S. Dollars, Euros, or British Sterling, and in any amount.

Please make check/cheque payable to Partners in Foster Care.
All payments must be in US Dollars

Forward payment with Form to
Cora E. White
IFCO-2005 Conference Secretary
P.O. Box 2534
Madison, WI 53701-2534

2003 __ Sep __Oct __ Nov __Dec

2004 __Jan __ Feb __Mar __Apr __ May __ Jun __Jul __ Aug __ Sep __ Oct __Nov __ Dec

2005 __ Apr __ May Early Deadline Ends

2005 __ Jun __ Jul __ Aug Conference Dates are August 7-13, 2005 Late Payment Fee Effective.

ifco2005-payment-plan

Special Payment Plan

Please indicate by Ö the items below you’d like to include in your payment plan. (Each fee is per person)

Please make check/cheque payable to Partners in Foster Care. All payments must be in US Dollars

Forward payment with Form to Cora E. White IFCO-2005 Conference Secretary P.O. Box 2534 Madison, WI 53701-2534

Please indicate by Ö the items below you’d like to include in your payment plan.
(Each fee is per person)

Please make check/cheque payable to Partners in Foster Care.
All payments must be in US Dollars

Forward payment with Form to
Cora E. White
IFCO-2005 Conference Secretary
P.O. Box 2534
Madison, WI 53701-2534