Pre-registration ends at 5:00 p.m. on April 2, 2008.

After that time, your registration will be processed at the walk-in registration table on April 5. Please print and fill out this form and bring it with you to facilitate processing.

Registration Form (one name per form - please print)
Important! Please read registration information

Save! Join now and attend the conference as a member.
Extended family and birthfamily members can attend under your membership.

 

_____________________________________________________
First Name/Last Name

_______________________________________________________________________
Member's First and Last Name if Different From Registrant

_______________________________________________________________________
Street

_______________________________________________________________________
City/State/Zip Code

_______________________________________________________________________
Telephone plus area code/Email for conference confirmation

 

Workshop Choices (Registrations are processed based on earliest postmark/fax receipt date with complete payment)

Workshop Time

1st Choice

2nd Choice

3rd Choice

9:30-10:45 a.m.

A______

A______

A______

11:00 a.m.-12:15 p.m.

B______

B______

B______

1:45-3:00 p.m.

C______

C______

C______

3:15-4:30 p.m.

D______

D______

D______

Presenter/Panelist:

__ No

__ Yes

    

Purchase Lunch Buffet:

__ No

__ Yes / $15

  

$_________

Family Membership:
(At One Address)

__ New / $50

__ Renewal / $50

  

$_________

Registration Fees, per person (PM=postmarked, FR=fax received date)

 

 

 

Member
(Per Person)

 

Non-Member
(Per Person)

Early Bird (PM/FR by 3/12)

 

$60

 

$125

Standard (PM/FR 3/13-3/27)

 

$90

 

$150

Late (PM/FR 3/28-4/5)
For registrations received after 5 pm 4/1, attendees need to bring their own lunch

 

$110

 

$175

 

 

 

 

 

 

 

 

 

Registration $_________

 

 

 

 

 

Donation (Please Check If You Prefer Anonymity)
___ Anonymous

 

Donation $_________

 

 

 

 

 

 

 

 

 

TOTAL $_________

Payment: ____ Check Enclosed -OR- Circle: Visa MasterCard Discover

Card Number_______________________________________________ Exp.________

Name on card __________________________________________________

3 Digit # on Back of Card ______________________________________

 

Parking:: ____ Will need handicapped parking

Mail or fax to: Adoption Community of New England, Inc.,
45 Lyman Street, #2 South Terrace, Westborough, MA 01581
Fax: 508.366.6813