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2008 Annual Training Conference Registration
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TO ASSIST IN REGISTRATION, PLEASE FILL OUT ALL OF THE INFORMATION ON THIS FORM COMPLETELY.
After you click "submit" you will have the opportunity to pay for your registration at PayPal.
You may also print out a PDF of the application and send it in with a check.
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Name*
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Address*
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City*
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State*
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Zip*
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Phone*
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Email*
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Please tell us about where you work
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Job Title*
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State
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Work Phone*
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Ext
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Agency Name*
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May we send confirmation to your e-mail?*
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Yes
No
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Are you a FIRST TIME NEW:PATHS Conference Attendee?*
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Yes
No
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Are you a Chapter Officer?*
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Yes
No
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Which office do you hold?
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*Agency Representative?*
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Yes
No
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*AGENCY MEMBERSHIP entitles one person from that Agency to Register as a member.
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Would you like to be a Moderator?
(Contact Linda McLain at mclainl@michigan.gov)*
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Yes
No
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Are you a Board member of a State or Local Chapter?*
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Yes
No
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Name of Chapter:
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FULL CONFERENCE Pre-Registration INCLUDES: Name badge (NAME WILL BE WRITTEN AS ABOVE), conference bag, conference program, admission to all concurrent workshops and general sessions, opening reception, breaks, meal functions, and admission to the annual business meeting.
DAILY CONFERENCE Pre-Registration INCLUDES: Name badge (NAME WILL BE WRITTEN AS ABOVE), conference bag, conference program, admission to all concurrent workshops and general sessions, breaks and meal functions for that day.
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EARLY BIRD RATES
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(Postmarked on or before August 1, 2008)
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Full Conference Member - $240
Full Conference NON-Member - $275**
Daily Rate Member - $100***
Daily Rate NON-member - $115
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**Includes one year membership
***If you are a DAILY attendee, please indicate the day you will be attending:
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LATE REGISTRATION RATES
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(Postmarked after August 1, 2008)
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Full Conference Member - $270
Full Conference NON-Member - $305**
Daily Rate Member - $115***
Daily Rate NON-member - $130
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What Special Assistance is needed?
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Vegetarian Meal
Wheel chair
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Other:
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CANCELLATIONS:
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All cancellations & changes must be in writing. There is a $30 fee for refund requests postmarked by 8/1/2008.
No refunds will be issued for cancellations & change requests postmarked after 8/1/2008
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If you have questions - contact: Katrina Henderson: 1-888-283-6392
Email: new@nationalnew.orgFor information about the Conference go to the Web Site for NEW: PATHS at www.nationalnew.org
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National Eligibility Workers Association t/a NEW: PATHS is a Non Profit 501(c) (6) membership association founded in 1975 for the
improvement of knowledge, skills and overall professionalism of eligibility staff.
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