Group Reservation
Name: ___________________________________________
Phone: ___________________
Organization: _____________________________________
Email: ____________________
We are interested in the following options with IMHER:
1. Employer discount ________
Number of employees: _______
Tentative date: _____________
(Discounted fee for a group of employees sponsored by the employer)
2. Host for workshop _________
Number of employees: _______
Tentative date: ______________
(Minimum of 8 pre-registered participants.)
3. Workshop Sponsorship ______
Please contact us for more information. (Customized program)
4. Other: __________________________________________
Please email to: [email protected]
or mail to:
Institute of Minority Health, Education, & Research (IMHER)
La Familia
841 West 21st St. North
Wichita , KS 67203
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