Name:
Organization/School:
Title (if any):
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Zip Code:
Phone No. (include area code):
E-mail Address:

Comments (if you're registering for other people, please include their names here):

If paying by mail, please make checks payable to:
     "Critical Islamic Reflections at Yale"
Mail checks to:
      CIR at Yale University
      P.O. Box 200915
      New Haven, CT 06520

Number of people you're paying for: person(s). (For each additional person, please add $10 for online registration)

Method of Payment: (For non-Yale registrants)
Mail: I will mail in a check for the registration fee(s) by April 1, 2006.
Online: I will pay now using a credit card via secure, fast PayPal.
On-site: I will pay on-site when I arrive on the day of the conference.