Register for the Conference - Step 1

Registration fees are as follows:

Full Conference (Oct. 8-9) - $160
One Day Only - $130
Full Conference Student (Oct. 8-9) - $110
One Day Only, Student - $75

If you need an accommodation for a disability, please contact Molly Malone at 763-427-5310 or 800-782-1878 on or before September 18, 2009.

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 ($160)
Regular Attendee - 1 Day, October 8, 2009 ($130)
Regular Attendee - 1 Day, October 9, 2009 ($130)
Student - 2 Days ($110)
Student - 1 Day, October 8, 2009 ($75)
Student - 1 Day, October 9, 2009 ($75)

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. (You will be redirected to our payment gateway)
I will pay with a check or PO. (MPRC will invoice you) PO Number:

Please Note: Registration will be due in full by October 8, 2009.

The 35th Annual Program Sharing Conference may be photographed and video recorded by MPRC staff. Registration and attendance of each participant of this conference acknowledges that as a participant you willingly give your permission to be video recorded and/or photographed, and that the recordings and photographs are the property of MPRC and may appear in promotional and marketing pieces, montages or on the MPRC website.

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 25, 2009. Fees are non-refundable after this date, but registration can be transferred to another person.

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	The Minnesota Prevention Resource Center (MPRC) is a project of the Minnesota Institute of Public Health with funding provided through a grant from the Alcohol and Drug Abuse Division (ADAD), Minnesota Department of Human Services
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