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Conference Registration - November 12, 2006 |
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The conference is offered free of charge. |
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| If your party includes more than one family, please register each family separately |
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Phone Numbers |
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How many Adults (over 12) would you like to register to attend the conference workshops and lectures (including yourself)?
Names of conference participants: |
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Would you like to reserve spaces in the Children’s Recreation Room (under 12)?
Yes, please reserve spaces for the following children: |
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Name: |
Age: |
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| Are you interested in volunteering? |
| I would like to volunteer on the day of the conference. |
| I would like to help recruit sponsors. |
| I live near South Orange, and I would like to volunteer before the conference. |
Financial assistance is available for travel expenses for the conference to those in need. Are you in need of financial assistance? Yes No |
Nurses Only: Would you like to receive continuing education units (CEU’s)? Yes No |
en Español: Would you like Spanish translation services at the conference? Sí No |
Discussion Panel Question:
The Discussion Panel session of our conference is an open-forum opporunity to ask CAH-affect adults to respond to any questions you may have about CAH. To maximize this session, all questions must be submitted in writing prior to the actual forum. (This also permits anominity.) While we will have Panel Question forms available during the conference, please feel free to use the space provided below to submit your question in advance. |
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Additional Comments: |
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