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Online Registration

Note:  Conference registration scholarships may be available.  For more information  please contact Yoko Allen at 702/298-9215.

 

Name:
 

Day Telephone:

 

Evening Telephone

 

Street Address:

 

City

 

State

 

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E-Mail Address

 Conference Registration

PRECONFERENCE:  July 15, 2008 1-5 pm

 Free but space is limited.  Please check below if you will attend.

The Person-Centered Approach--Past, Present, and Future    Bruce Allen, Ph.D.

 

CONFERENCE REGISTRATION FEE:  Conference begins, 7 pm, July 15, 2008 and ends Noon, July 19. 

Please Check One:

$350 registration fee for ADPCA members mailed/submitted April 1, 2008 or later

$450 registration fee for non-ADPCA members mailed April 1, 2008 or later

Dormitory Fees

(Note:   You do not have to stay in the dormitory.  If you choose to though,  you may check in as early as Friday July 11, 2008 and check out as late as Sunday, July 20, 2008. The registration does not include food.)

Check in Date
Check out Date

DORMITORY ROOMS, PER NIGHT

$40 Single Room (Shared Bath)  X Nights= Total Room Fee
          

                   Or:

 

$22 Double X

  

 

                                                 

Nights=

 

 

 

Total Room Fee

     

If you would like particular room mate, please indicate whom: 

Payment

Total Amount to be charged:  Registration Fee + Dormitory Fee =

To:

Mastercard #                    Expires (mm/dd/yy)
Or:

Visa

                                                              

#

 

Expires (mm/dd/yy)

     

You may also use Paypal to send money for ADPCA Conference.  Please use adpca@cmaaccess.com 

Questions:  Please Contact Yoko Allen at 702/298-9215 or at adpca@cmaaccess.com

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