ATFCPA
2002 Annual
Therapeutic Foster Care
Conference
Building Partnerships: Working Hand-in-Hand
October 2-4, 2002
Embassy Suites, Montgomery, Alabama
The Alabama Therapeutic Foster Care Providers Association (ATFCPA) is dedicated to promoting more consistent and quality treatment services for therapeutic foster care children.
Print this form to fill in and fax to (334) 269-6314
Early Registration Deadline is September 20, 2002!
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Please return entire panel to (Please keep a copy for your records.) |
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ATFCPA, C/O P.O. Box 70245, Montgomery, AL 36107 Fax: (334) 269-6314 Registration Information (Please type or print) Name__________________________________Title____________________________________ Company/Organization____________________________Email___________________________ Address____________________________City/State/Zip_______________________________ Phone ____________________________Fax _________________________________________ Check Payment Method: Check Money Order |
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Registration Fees |
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To pre-register, your registration, change, or replacement must be received by ATFCPA by September 20, 2002. After this date, all registrations will be processed as on-site registrations. Phone cancellations are not accepted. If registration is cancelled, fees will be refunded as follows: Prior to September 20-full refund less $20 administration fee; September 21-30-50%; No refunds after September 30, 2002. |
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Check Fee Category |
Prior to 9/20 |
After 9/20 |
Continuing Education Credits |
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Clinician* |
$95.00 |
$115.00 |
$10.00 |
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Please select professional designation for CEUs LPC Social Worker * Clinicians-Registration fee includes Banquet and Lunch. However, please check below if you will be attending these events. |
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Foster Parent (must submit copy of license) Full conference (12 training hours) |
$30.00 |
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One Day* |
$10.00/day |
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*Foster Parent: Please check which day(s) you will be attending: (training hours in parenthesis) Wednesday-10/2 (3 hrs.) Thursday-10/3 (6 hrs.) Friday-10/4 (3 hrs.) |
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Student (must submit copy of student ID; training certificate provided) |
$25.00 |
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I will also be attending the following event(s) (foster parents and students: be sure to enclose the conference fee plus the fee(s) for any events you will be attending): |
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Banquet w/George Duvall |
$27.00 |
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Lunch w/State Representative Mike Hubbard |
$20.00 |
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Total Enclosed: $_______________ |
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Email:
ATFCPA