ONLINE REGISTRATION FORM

You may e-mail this Registration form upon completion or copy, complete it and fax it to (847) 249-2772

A.- Registration and Tuition Fees *

	Before 31May	After 31May	Number of Attendees
Non-APAL members	US$350.00	US$420.00
Accompanying guest(s)-per person	US$120.00	US$120.00
Residents, Students	US$100.00	US$120.00
RN's, Psychologists & Social Workers	US$120.00	US$150.00

Closing Dinner-Show & Dance US$30.00 x number of guests

Total Number of Individuals:

* The Tuition fee includes entrance to all scientific sessions, participation in the Opening Ceremonies, receipt of program and Certificate of Attendance, and social/cultural activities scheduled by the Congress organizers, excluding the Closing Banquet-Dance on Friday 22SEP. The Tuition Fee is NON-refundable.

Samples of round-trip airfares as of 01May 2000 start at: Seattle-Lima, US$505.00, New York-Lima, US$495.00, Chicago-Lima, US$565.00, Dallas/Houston-Lima, US$495.00. The sooner you make your reservation, the best value you get for your meeting dollars. Call MILA today for a quotation from your city of origin: 1 800 367-7378, or eM milalatin@aol.com Prices are subject to change by airlines.

LIMA 19-24 SEP. It includes transfers airport-hotel-airport, 5 nights Hotel accommodations, daily American or buffet breakfast, a city tour including a visit to the Catacombs of San Francisco Church, bilingual guide, local service taxes and international medical assistance service.

HOTELS

Marriott, Sheraton, Miraflores Pk And/or Country Club Hotel US$535.00 p. person x number of guests

Total Number of Individuals:

Del Pilar, La Paz, Antara and/or Maria Angola Hotel US$445.00 p. person x number of guests

Total Number of Individuals:

Please select:

PRE 15-20 SEP

POST 24-29 SEP

CUZCO 15-20 SEP or CUZCO 24-29 SEP It includes the first or last night in Lima. Four nights in Cuzco including an overnight in the Machu Picchu area. All airport, hotel & train station transfers, hotel accommodations, round-trip train to Machu Picchu, 5 buffet breakfast, 2 lunches, Cuzco archaeological city tour, bilingual guides, local Service taxes, domestic [Peru] airport taxes & entrance fees to Museums/Parks

LAND US$820.00 pp. x number of guests

Total Number of Individuals:

AIR Lima-CUZCO-Lima US$202.00 pp. x number of guests

Total Number of Individuals:

Please select:

PRE 15-20 SEP

POST 24-29 SEP

AMAZON JUNGLE 15-20 SEP or 24-29 SEP. It includes the first or last night in Lima, four nights in the Jungle, ALL meals, all scheduled tours, a healing session with the local Shaman, all transfers, lodge Accommodations, bilingual guides, entrance fees, local service taxes and domestic [Peru] airport taxes.

Land US$495.00 pp. x # of guests

Total Number of Individuals:

AIR Lima-Amazon Jungle-Lima US$202.00 pp x # of guests

Total Number of Individuals:

Please select:

PRE 15-20 SEP

POST 24-29 SEP

GALAPAGOS 15-20 SEP or 24-29 SEP. It includes one night hotel accommodations in Quito or Guayaquil, Ecuador, round trip air from mainland Ecuador to the Islands, 4 nights on a boat cruising the Galapagos; all meals and scheduled tours on board, bilingual professional nature guides, local service taxes, all transfers, full american/buffett breakfasts in hotel.

Land & Cruise starts at US$1565.00 pp. x # of guests

Total Number of Individuals:

Galapagos entrance tax US$100.00 pp. x # of guests

Total Number of Individuals:

At MILA we can design the program of YOUR choice. Please eM: milalatin@aol.com, or call 1 800 367-7378 to coordinate all aspects of your trip.

CONGRESS PARTICIPANT and Guests

Title	Select One Dr. Mr. Ms.
Name
Mailing Address
City		State
Zip
Telephone (work)		Fax
Email
Telephone (home)
Name of emergency contact
Phone Number of emergency contact
Accompanying Guests:
1. Title: Select One Dr. Mr. Ms. Name:		Age if Minor:
2. Title: Select One Dr. Mr. Ms. Name:		Age if Minor:

With full payment of tuition fee, a 50% of land portion is due. Full balance due by July 20, 2000. Late payment fee is US$40.00 per person. The tuition fee is non-refundable. Cancellation penalities may be applied by the airlines, hotels and tour operators. Please request printed cancellation information.

Grand Total:

Payment Method: Select one Visa Mastercard American Express Check

If paying by check, make payable to MILA/APAL Peru. Please mail check to 100 S Greenleaf, Gurnee, IL 60031.

Account number:


Exp Date (MM/YY)