Register for the Conference - Step 1

Register for the Conference - Step 1

Registration fees are as follows:

Attendee, 1 Day - $100
Attendee, 2 Days - $130
Student, 1 Day - $50
Student, 2 Days - $90

Registration fees after June 20th are as follows:

Attendee, 1 Day - $130
Attendee, 2 Days - $160
Student, 1 Day- $75
Student, 2 Days- $110

Register by June 20th to be entered into our drawings to have your registration fee waived.

You may pay either by purchase order, check or with a credit card.

Please enter the following information (required information is in bold text):
First Name:
Last Name:
Company:
Address:
City:
State:
ZIP:
Phone:
Fax:
E-mail:

Please choose a registration option:

Regular Attendee - 2 Days ($130)
Regular Attendee - 1 Day, October 1, 2008 ($100)
Regular Attendee - 1 Day, October 2, 2008 ($100)
Student - 2 Days ($90)
Student - 1 Day, October 1, 2008 ($50)
Student - 1 Day, October 2, 2008 ($50)

This is my first time attending Program Sharing

Special Requests:

Vegetarian Meal:

Please indicate any other special needs or comments here

Please select payment method

I will pay with a credit card. (MPRC will call for my credit card information)
I will pay with a check or PO. (MPRC will invoice you) PO Number:

Please Note: Registration will be due in full by October 1, 2008.

Cancellation Policy: Registration fees, minus a $30 administration fee, will be waived if cancellation is made in writing to the Minnesota Prevention Resource Center's office on or before September 17, 2008. Fees are non-refundable after this date, but registration can be transferred to another person.

	The Minnesota Prevention Resource Center (MPRC) is a project of the Minnesota Institute of Public Health with funding provided through a grant from the Chemical Health Division, Minnesota Department of Human Services
	© Copyright 2007 Minnesota Institute of Public Health. We appreciate your comments and suggestions to help our site be more useful.