INTERNATIONAL HUMAN LEARNING RESOURCES NETWORK

Return this form before September 1, 2022 if you are NOT attending the annual conference in La Quinta, CA, November, 2022, but wish to remain on the IHLRN mail list and support our association. Please send a check for $25 payable to IHLRN to: Cynthia Brooks, 4214 Emet Court, San Diego, CA 92117

Name(s):______________________(BA, MS, PhD, blah, blah, etc.) _______

Address:___________________________________________

City:__________________________ State:____ Zip code:_______

Country:__________________________________   

Phone: (h)____________________(cell) ___________________

Email: _________________________

Please check as many of the following statements as apply to you:

____ My/our address is either new or corrected.

____ I/we am/are enclosing a check in the amount indicated below:

         $______ To continue on the IHLRN Mailing List $25

         $______ Additional donation to IHLRN Scholarship Fund

         $______Total amount enclosed

We thank you for your support!!