1 California Chapter - Summer 2017 Seminar Saturday, June 24 2017 ...
California Chapter - Summer 2017 Seminar Saturday, June 24 2017 Newport Beach Marriott Bayview * Newport Beach, CA Registration Application
Please save on your desktop, as this version allows an easier preparation of the information as you can directly type into the form fields below. Date: Prefix (Mr., Mrs., etc): First/Last Name: Company: Street: City: State:
Zip Code:
Telephone Number: Email Address: Continuing Education Units Continuing Education Units (CEU’s) will be available. CEU’s for ethics and general credits will be available to all CRC, CDMS, CLCP, and ABVE. The CEU forms will be available onsite at the registration desk and will include more detailed information needed on how to obtain CEU’s.
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Conference Meals (Please let us know if you will/will not be attending). Saturday, June 24 – Continental Breakfast (7:15AM– 8:15AM) Yes: No: Saturday, June 24 – Lunch (12:15PM-1:30PM) Yes: No: Dietary Restrictions/Allergies Yes: No: We do our best to accommodate special meal requests (vegetarian, vegan, gluten free, allergies, etc.) during all conference meal functions. Individuals that notify us of a special meal request by the deadline date will be provided with a meal based on their dietary needs. Because these meals are pre-ordered before the conference, special meal requests received after the deadline date or onsite cannot be guaranteed. Deadline date is Friday, June 16, 2017. Please describe dietary restrictions here (vegetarian, allergic to, vegan, etc.)
Other Accommodations please list here:
Electronic Program Booklet and Participant Directory List: There will be no hardcopy of the conference program booklet. You will receive an electronic, accessible, pdf conference program booklet, via email to the address you provided when you registered, 4 days before the conference begins. For the electronic, accessible, pdf conference program booklet to be completed and emailed to everyone registered in a timely manner, any registrations after Monday, June 19, 2017 will not be included in the participant directory list.
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Registration Type and Fee Registration includes all conference materials, name badge, access to all meals, presentations to include CEU’s for all attendees. Non-Member of IARP Early Bird Rate Ends – Friday, June 16, 2017 – $180.00 Standard Rate Begins – Saturday, June 17, 2017 – $200.00 IARP Member Early Bird Rate Ends – Friday, June 16, 2017 – $150.00 Standard Rate Begins – Saturday, June 17, 2017 – $170.00 Student Member Early Bird Rate Ends – Friday, June 16, 2017 – $40.00 Standard Rate Begins – Saturday, June 17, 2017 – $60.00 Terms/Conditions Friday, June 9, 2017 - Refunds due to cancellation will be determined on an individual basis and will not be issued after this date. Friday, June 9, 2017 - Substitutions will be allowed without any penalties if the registration type and fee is the same. Other fees will apply if the substitution will require a credit card payment and there is a change in the registration fee. Refunds will be subject to an administrative fee of $25.00 dollars. Please Note All final payments need to be received by Friday, June 23, 2017. Receipt of the confirmation email does include you in the count for food and conference materials, regardless of payment type. If you have any questions or concerns regarding payment, please contact Jill Peterson at [email protected] Questions For additional questions regarding seminar, registration, or hotel accommodations please contact Mary E. Jesko at mailto:[email protected] Check Payment for Registration Please print your registration application and include with payment. Check should be written to: IARP CA Chapter Mail Check Payment with Registration Application to: Jill Peterson 3100 Oak Road, Suite 390 Walnut Creek, CA 94597
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Please save on your desktop, as this version allows an easier preparation of the information as you can directly type into the form fields below. Date: Prefix (Mr., Mrs., etc): First/Last Name: Company: Street: City: State:
Zip Code:
Telephone Number: Email Address: Continuing Education Units Continuing Education Units (CEU’s) will be available. CEU’s for ethics and general credits will be available to all CRC, CDMS, CLCP, and ABVE. The CEU forms will be available onsite at the registration desk and will include more detailed information needed on how to obtain CEU’s.
1
Conference Meals (Please let us know if you will/will not be attending). Saturday, June 24 – Continental Breakfast (7:15AM– 8:15AM) Yes: No: Saturday, June 24 – Lunch (12:15PM-1:30PM) Yes: No: Dietary Restrictions/Allergies Yes: No: We do our best to accommodate special meal requests (vegetarian, vegan, gluten free, allergies, etc.) during all conference meal functions. Individuals that notify us of a special meal request by the deadline date will be provided with a meal based on their dietary needs. Because these meals are pre-ordered before the conference, special meal requests received after the deadline date or onsite cannot be guaranteed. Deadline date is Friday, June 16, 2017. Please describe dietary restrictions here (vegetarian, allergic to, vegan, etc.)
Other Accommodations please list here:
Electronic Program Booklet and Participant Directory List: There will be no hardcopy of the conference program booklet. You will receive an electronic, accessible, pdf conference program booklet, via email to the address you provided when you registered, 4 days before the conference begins. For the electronic, accessible, pdf conference program booklet to be completed and emailed to everyone registered in a timely manner, any registrations after Monday, June 19, 2017 will not be included in the participant directory list.
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Registration Type and Fee Registration includes all conference materials, name badge, access to all meals, presentations to include CEU’s for all attendees. Non-Member of IARP Early Bird Rate Ends – Friday, June 16, 2017 – $180.00 Standard Rate Begins – Saturday, June 17, 2017 – $200.00 IARP Member Early Bird Rate Ends – Friday, June 16, 2017 – $150.00 Standard Rate Begins – Saturday, June 17, 2017 – $170.00 Student Member Early Bird Rate Ends – Friday, June 16, 2017 – $40.00 Standard Rate Begins – Saturday, June 17, 2017 – $60.00 Terms/Conditions Friday, June 9, 2017 - Refunds due to cancellation will be determined on an individual basis and will not be issued after this date. Friday, June 9, 2017 - Substitutions will be allowed without any penalties if the registration type and fee is the same. Other fees will apply if the substitution will require a credit card payment and there is a change in the registration fee. Refunds will be subject to an administrative fee of $25.00 dollars. Please Note All final payments need to be received by Friday, June 23, 2017. Receipt of the confirmation email does include you in the count for food and conference materials, regardless of payment type. If you have any questions or concerns regarding payment, please contact Jill Peterson at [email protected] Questions For additional questions regarding seminar, registration, or hotel accommodations please contact Mary E. Jesko at mailto:[email protected] Check Payment for Registration Please print your registration application and include with payment. Check should be written to: IARP CA Chapter Mail Check Payment with Registration Application to: Jill Peterson 3100 Oak Road, Suite 390 Walnut Creek, CA 94597
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