Registration and Fees


REGISTRATION:

Please register me for the We've Got To Talk About It conference, July 14 ¨C15, 2006. (Please print or type using one form per person.)
Name : ____________________________________________________________________

Organization:_______________________________________________________________

Mailing Address: ____________________________________________________________

City, State, Zip code: _______________________________________________________
Home Phone _______________________ Work Phone __________________________
Email_____________________________ Fax _________________________________


Workshop Preferences

Please include your first, second, and third choices by writing the number of the workshop in the appropriate space. All workshops are offered in both the morning and the afternoon.
Morning Afternoon
First choice
Second choice
Third choice

Registration fee after June 14, 2006: $60


Check enclosed $:___________________________________________________________

Purchase order enclosed #:___________________________________________________


Continuing Education credits: circle one if it applies to you
  • CEU¨- NASW: 7

  • CLE - COSB: 3.5

  • Graduate Ed credit - PSU CSEd:1


Scholarships

Scholarships are available to those with demonstrated need. For a scholarship, send your written request to the Women's Studies department.

Organizations sending multiple staff members may send three for the price of two. Please include all completed registrations and fees in the same envelope.



Catered Lunch

Lunch includes choice of sandwich, and is served with chips, cookie or fresh fruit, and bottled water or soda: $12 $ Please indicate preference:

  • Turkey
  • Roast Beef
  • Vegetarian


Child Care (available on Saturday only)
Do you need child care?

  • yes
  • no

Number of children Ages of children: ____________________________________________


Total payment included $:___________________________________________________


Make check or money order payable to: Women's Studies Department Send with registration form to: Portland State University, Women's Studies Department, PO Box 751, Portland OR 97207-0751

For office use only:

Check #
Purchase Order #