Registration | Florida Consortium for International Education

FCIE 2021 Workshop Form

First and Last Name*

Institution*

Phone*

Email*

Affiliation*

FCIE
Study Florida
FAIE

Please select your choices*

One-day registration
Two-day registration
I am a presenter

Please input any questions you wish to be addressed during the discussion

Meals Attending*

Thursday, Oct. 6 Lunch 12:00-1:15 p.m.
Thursday, Oct. 6 Banquet Dinner 6:00-9:00 p.m.
Friday, Oct. 7 Lunch 12:00-1:00 p.m.
I am requesting vegetarian meals.

Indicate the number and type of additional tickets you need (lunch $25 each; dinner banquet $40 each)

Total Amount to Charge

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Credit Card Number

Expiration Month

Security Code

Credit Card Billing Address

Street Address Address Line 2 City State ZIP Code

Authorization*

Please enter your name here. By clicking on the Submit button below, you are authorizing Valencia College, on behalf of FCIE, to process this credit card charge for the amount indicated above.

Name

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Workshop Registration

FCIE 2021 Workshop Form