Conference Registration | Florida Consortium for International Education

FCIE Event Registration 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

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

Name on the Credit Card

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

This field is for validation purposes and should be left unchanged.