Adaptive Solutions Website : Annual Conference

Conference Registration
To register for the conference, please fill in the following:
Preconference - Wednesday, May 2nd - $125 Thursday, May 3rd - $100 Friday, May 4th - $100 One Day Rate - $125 Full Time Student Rate - $50
On site registrations will be $15.00 more.
Indicate Pre-Conference Choice(s):

PC-1 PC-2 PC-3 PC-4 PC-5 PC-6 PC-7 PC-8 PC-9 PC-10
Full Name*

Address*

Street Address
City	State / Province
Postal / Zip Code	Country

E-mail*
Payment Method
Parish/Agency where you work:
PO Number:
Continuing Education Credit Needed?

Yes No
Should be Empty:

Your registration can only be processed with PO # or check - No Exceptions.
Payment must be made by the first day of the conference. You can email, fax or mail your PO and registration form.

2127 Court Street - Port Allen, Louisiana - 70767
Telephone: (225) 387-0428 - Fax: (225) 387-6092
Email: sherry@adaptive-sol.com

Conference Registration