Registration Form:  Available NOW!!!


New York Association of Specialists in Group Work Conference Rates






         *  Thursday registration includes continental breakfast, lunch, two breaks, and reception.
       **  Friday registration includes continental breakfast and two breaks.
    ***  Total conference registration include both Thursday and Friday meals, breaks, and reception.
  ****  Forms must be mailed together to qualify for discount.

 


 



Pre-registration deadline:  May 6th 2006 
No refund will be made after this date.
Commission on Rehabilitation Counseling (CRC) credits available upon request.

Continuing Education credits through the National Board of Certified Counselors (NBCC) available upon request





Registration Form







Name __________________________________________________________________________
Organization __________________________________________________________________________
Address __________________________________________________________________________
City                                                           State                                    Zip Code __________________________________________________________________________
Phone Number  (     )                              Fax  (     )                              E-mail             __________________________________________________________________________
 









Fees

Wednesday Only  _____________ 
Thursday Only      _____________
Friday Only            _____________

Wed & Thurs        _____________ 
Wed & Fri              _____________
 Thurs & Fri           _____________ Entire Conference _____________


MAKE CHECKS PAYABLE TO:

NYASGW









 

 








ON SITE REGISTRATIONS ADD $15 PER DAY OR $30 FOR ALL 3 DAYS





 

 

Circle One:

                            Student         Professional            Group Rate*             Presenter

Wed.                       75                        95                         85                             80

Thursday               55                        70                         70                             65

Friday                     75                        90                         85                             80

Wed & Thurs        118                      135                       130                           125


Wed & Fri              140                      160                       155                            150


 Thurs & Fri           118                      135                       130                            125

All 3 Days              185                      215                       210                            200

 

     All include a 1-year membership to NYASGW valued at $15.


 * 3 or more forms must be mailed together to qualify for the discount.





 Return to:  

UNIVERSITY AT BUFFALO, SUNY                                                                                                             CSEP, 409 BALDY HALL                                                                                                                      BUFFALO,  NY  14260    
 ATTN:  Janice DeLucia-Waack

 
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