The Southern Regional Council and

The Civil Rights Movement

Registration Form

Please print form and include it with your check made payable to "University of Florida Foundation." Indicate below which package you have chosen:

Ù Conference Package A: $25.00

Includes registration and refreshments during session breaks.

Ù Conference Package B: $90.00

Includes registration, refreshments during session breaks, receptions, lunches, and dinners.

Print Name: ________________________________________________

Sign Name: ________________________________________________

Date: ________________________________

Send registration form along with payment to the following address:

SRC Conference

University of Florida

Department of History

P.O. Box 117320

Gainesville, FL 32611-7320