Chi
Sigma Iota-Beta Upsilon Chapter
and
Barry University
Counselors' Association - Orlando
Graduate Student Conference
‘09
April 24, 2009
REGISTRATION
FORM
Name: (for name badge) ________________________________________________________________
(first)
(last)
University/Organization:
________________________________________________________________
Address:_____________________________________________________________________________
City:
________________________________ State: ________ Postal/Zip Code: ________
Telephone:
(______)__________________ Fax: (______)____________________
Email: _______________________________
Registration Fees - Includes the cost of registration, list of abstracts, and continental breakfast.
Postmarked
by April 13, 2009 $5.00
Please list any ADA Special Needs:
______________________________________________________________________
__________________________________________________________________________________________________
Cancellations
and Refunds: Registration fees will be refunded if cancellation is received in writing no later than April 13, 2009.
After that date, registration fees are non-refundable. All refunds will be processed after the conference. Substitutions
are allowed.
PAYMENT METHOD
Please remit payment by Checks and Money Orders in
U.S. funds payable to: Barry University Counselors' Association - Orlando.
There
will be a $12.00 fee charged on checks returned by the bank due to insufficient funds.
(Please
check appropriate box): □ Check □ Money Order
□ Cash
Please mail completed registration form with payment to:
Barry University Counselors' Association - Orlando
Barry University
2000 N. Alafaya Trail, Suite 600
Orlando FL 32826
Questions directed to Dr. Christine Sacco-Bene
Phone: (321) 235-8411
Email: csacco-bene@mail.barry.edu
