Supported Life 2008 - October 8 - 10, 2008

Online Registration
Order #8285-1

1.

First Name    Last Name

leave name information blank and check here if this registration is for a yet-to-be-determined attendee
      (e.g. you do not yet know his or her name, but your organization is purchasing a block of registrations)
2.

Affiliation/Agency Name

3.
Address
4.
City    State    Zip Code
5.
Daytime Telephone ( )       

Email Address
6.

I am a (select one):    

Professional
Person with a disability (paying FULL FEE) Our Co-sponsors’ generosity allows us to offer a Reduced Fee for people with developmental disabilities & their family members.  To maximize this generosity, please only make use of the Reduced Fee if it is financially necessary.  For the same reason, we ask consumers or family members working in the disabilities field to ask your agency to pay the Full registration fee, if possible.
Person with a disability (paying REDUCED FEE)
Family Member (paying FULL FEE)
Family Member (paying REDUCED FEE)
Personal Care Attendant (paying FULL FEE)
Personal Care Attendant (paying REDUCED FEE)
Full-Time Student (you must mail or fax proof of current full-time student status to Supported Life)

SPEAKERS: Do not register online. Use the speaker registration form that was mailed to you.
7.

I will be attending (check all that apply):

Wednesday evening Inclusion Celebration
      ($15 will be deducted from the Inclusion Celebration price, if you are also registering for the Conference)
Thursday conference day
Friday conference day
8.
 $
  • If you are purchasing more than one registration, this amount will be added to your total
  • Javascript must be enabled in your browser in order to see your total cost reflected here. Your total cost will be visible on the next screen (prior to checking out).
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    9.

    Accommodations requested:

    Medically-recommended diet
    Vegetarian lunch preferred
    Sign Language interpreting services
    Conference materials in Braille or large print

          Please specify request (note: all requests for accommodations must be received in
          the Supported Life Institute office by September 18, 2008    ):
            

    10.

    My 1st choice for each concurrent session time:
    Marking your initial choices helps us assign session rooms, but you may attend any session on the actual conference days.
    ALSO, please check below if you plan to attend Orientation on Thursday 8:00 - 8:30 a.m.

    THU 10/9
    THU 10/9
    THU 10/9
    FRI 10/10
    FRI 10/10
    Thursday morning Orientation 8:00 a.m.
    		  
    10:15 - 11:30
    2:00 - 3:15
    3:30 - 4:45
    9:45 - 11:00
    11:15 - 12:30
    101
    201
    301
    401
    501
    102
    202
    302
    402
    502
    103
    203
    303
    403
    503
    104
    204
    304
    404
    504
    105
    205
    305
    405
    505
    106
    206
    306
    406
    506
    107
    207
    307
    407
    507
    108
    208
    308
    408
    508
    109
    209
    309
    409
    509
    110
    210
    310
    410
    510
    Thursday evening Panel Discussion 7:30 p.m.
    411
    511

  • Click only once, then wait for the order summary page
  • You will have an opportunity to add additional registrations to your order prior to checking out.
  • SERVICE AGENCIES! Purchase five "Professional" registrations in a single online order and receive a sixth "Professional" registration free of charge! When you fill out your sixth professional registration, the cost of the lowest-priced professional registration in your order will automatically be deducted from your order. This will be visible on the summary page after submitting the sixth professional registration.

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