Conference Registration | Morgan Autism Center

Conference Registration

September 25, 2009 - Friday @ Santa Clara University

Opening Presentation at Recital Hall (includes reception to meet and greet speakers immediately following @ Adobe Lodge)

$45 pp/$60 pp at the door Amount _____________

_____________________________________________________________________________

September 26, 2009 - Saturday @ Santa Clara University

All day conference (includes coffee/rolls/afternoon snack)

$100 pp/$125 pp at the door Amount _____________

Please check for Saturday Conference Only:

_____CMES available for RN, MD, PHD, LCSW and LMFT for Medical portion on Saturday.

_____CEUS - 7 Continuing Education Credit hours provided via Professional Developmental

Dept - Santa Clara University - $50 for CEUS to be paid at conference.

_____ 6.5 CEUS - Speech Language Pathologists provided via Peninsula Associates - $15 for

CEUS to be paid at conference.

Please select the Breakout Session you wish to attend:

_____Breakout #1 - Raun Kaufman

_____Breakout #2 - Shannon McCord

_____Breakout #3 - Mike Gilfix

_____Breakout #4 - Nicholas Boldrey

_____________________________________________________________________________

September 28, 2009 - Monday @ Morgan Autism Center

Special Training Session of Son-Rise Program (includes coffee and lunch)

$50 pp/$65 pp at the door Amount _____________

Total Amount ______________

_____________________________________________________________________________

Deadline to register by Mail or Fax is September 22, 2009.

Deadline to register by Phone is September 25, 2009.

All cancellations must be received in writing by mail, e-mail or fax by September 22, 2009. There is a $70 processing fee per person for all cancellations prior to September 22, 2009. No refunds will be issued after September 22, 2009.

Please visit our website for easy on-line registration starting July 15, 2009.

Please mail your completed form with your check made payable to:

Morgan Autism Center

2280 Kenwood Avenue,

San Jose, CA 95128

-OR- fax this form with your Credit Card Information to 408-241-8231

Name________________________________________________________________

Address______________________________________________________________

CC#________________________________________ Exp. Date________________

Amount of Charge_____________________________

	Home Blog About Us Programs Services Workshops and Lecture Series Conference Video Highlights Events FAQs Donations School Accountability Report Card Contact Us	Conference Registration Conference Registration September 25, 2009 - Friday @ Santa Clara University Opening Presentation at Recital Hall (includes reception to meet and greet speakers immediately following @ Adobe Lodge) $45 pp/$60 pp at the door Amount _____________ _____________________________________________________________________________ September 26, 2009 - Saturday @ Santa Clara University All day conference (includes coffee/rolls/afternoon snack) $100 pp/$125 pp at the door Amount _____________ Please check for Saturday Conference Only: _____CMES available for RN, MD, PHD, LCSW and LMFT for Medical portion on Saturday. _____CEUS - 7 Continuing Education Credit hours provided via Professional Developmental Dept - Santa Clara University - $50 for CEUS to be paid at conference. _____ 6.5 CEUS - Speech Language Pathologists provided via Peninsula Associates - $15 for CEUS to be paid at conference. Please select the Breakout Session you wish to attend: _____Breakout #1 - Raun Kaufman _____Breakout #2 - Shannon McCord _____Breakout #3 - Mike Gilfix _____Breakout #4 - Nicholas Boldrey _____________________________________________________________________________ September 28, 2009 - Monday @ Morgan Autism Center Special Training Session of Son-Rise Program (includes coffee and lunch) $50 pp/$65 pp at the door Amount _____________ Total Amount ______________ _____________________________________________________________________________ Deadline to register by Mail or Fax is September 22, 2009. Deadline to register by Phone is September 25, 2009. All cancellations must be received in writing by mail, e-mail or fax by September 22, 2009. There is a $70 processing fee per person for all cancellations prior to September 22, 2009. No refunds will be issued after September 22, 2009. Please visit our website for easy on-line registration starting July 15, 2009. Please mail your completed form with your check made payable to: Morgan Autism Center 2280 Kenwood Avenue, San Jose, CA 95128 -OR- fax this form with your Credit Card Information to 408-241-8231 Name________________________________________________________________ Address______________________________________________________________ CC#________________________________________ Exp. Date________________ Amount of Charge_____________________________