Please submit one
registration form per attendee per event. If you prefer to mail or fax a
registration form, you may download a
registration page (pdf) or a copy
of the complete registration
brochure (pdf). This Forum is limited to 150 participants. There
will be NO ONSITE REGISTRATION.
Lunch, breaks and training materials are included in the registration fee. REFUND POLICY:
Since this is a limited participation Forum, no requests for refunds will be
honored after January 15, 2010. Any refund requests prior to January 15, will be subject to a 25% handling charge
and should be submitted in writing.
Please choose one of the following registration options:
Member of CEC/CCBD - $350 (by 12/30) or $375 (12/31 or later)
Member
Number:Expiration:
Regular Non-Member - $375 (by 12/30) or $400 (12/31 or later)
Staff
and Planning Committee (Pre-approval required)
Team Discount:
If you are a member of a team (3 or more people from the same
district/agency/institution), you may take 10% off your registration. All
team members must complete a separate registration form. Online credit/debit
payments may be made individually, however, all payments by mail or fax should
cover the entire team. Sorry, we cannot accept team
registrations sent individually.
Team Names (if applicable):
PAYMENT INFORMATION:
USA Funds only please. Payable to CCBD-PDC (Fed ID #54-1777499)
Summary:
Conference Registration Rate
(Don't forget to include your 10% discount if you are part of a team)
Type of Payment:
Check (mail with copy of registration form)
Check #
Purchase Order (mail or fax with copy of registration form)
Purchase Order #
Credit/Debit Card - After
you submit your registration using the SUBMIT button below, you will receive a
confirmation page with an opportunity to enter your credit/debit card
information and activate your registration.
SPECIAL NEEDS: Please indicate if you have any special needs or requests.
