2010 WACYCP Conference Registration Form
First Name
Last Name
Agency Name
Address
City
State
Zip
Phone Number
Fax Number
Email Address
Bill To Agency
Agency Address
Agency City
Agency State
Agency Zip
Billing Invoice should go to the Attention of:
Workshop Selections (Please choose only ONE per
session)
Day One May 25th Session A
Session A1
Session A2
Session A3
Session A4
Session A5
Session A6
Session A7
Session A8
Workshop Selections (Please choose only ONE per
session)
Day One May 25th Session B
Session B1
Session B2
Session B3
Session B4
Session B5
Session B6
Session B7
Session B8
Workshop Selections (Please choose only ONE per
session)
Day One May 25th Session C
Session C1
Session C2
Session C3
Session C4
Session C5
Session C6
Session C7
Workshop Selections (Please choose only ONE per
session)
Day Two May 26th Session A
Session A1
Session A2
Session A3
Session A4
Session A5
Session A6
Session A7
Session A8
Workshop Selections (Please choose only ONE per
session)
Day Two May 26th Session B
Session B1
Session B2
Session B3
Session B4
Session B5
Session B6
Session B7
Session B8
Workshop Selections (Please choose only ONE per
session)
Day Two May 26th Session C
Session C1
Session C2
Session C3
Session C4
Session C5
Session C6
Session C7
Workshop Selections (Please choose only ONE per
session)
Day Three May 26th Session A
Session A1
Session A2
Session A3
Session A4
Session A5
Session A6
Session A7
Full Conference Fees
$125 (current member/agency member)
$150 (Includes conference and membership)
$200 (non-member)
Add on : WACYCP Award Event (held Wed May 26th)
$25.00
Add on: National Certification Testing
(Conducted During the Conference)
$75.00
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