Click here to view Conference brochure.



Note: All attendees must register for the Conference (See payment
options below.). Conference materials will not be available to
attendees who do not register. Registration is required even if
you have attended previous “I Care” Conferences.


Registration Form

* Required Information

Step 1: Conference Phase

* Please indicate which phase you will attend:

(If you have never attended a conference, please select Phase I. If you have completed Phase I training and are returning to complete your certification, please select Phase II. If you are already certified and are returning for Advanced Training, please select Advanced)

Phase I         Phase II         Advanced


Step 2: Conference Attending

* Please indicate which Conference you will attend:

June 24-26, 2015; Atlanta, Georgia


Step 3: Registration Information

(Please provide the indicated information, taking note of the required information.)

*Name:

*Title/Position:

*School/Organization:

*Address 1:

Address 2:

*City:

*State:

       *Zip:

*Telephone:

FAX:

*E-mail address:

*Shirt size:

Special Needs:


Step 4: Payment Information

(Please provide the indicated information, taking note of the required information.)

*Payment by:

Check

Purchase Order

Credit Card (You will have the option to pay by credit card after you submit your registration.)

Purchase Order Number:


(Please fax the Purchase Order to 229.928.9922.)
 

Please make checks payable to:

“I Care” Products & Services
P.O. Box 492
Americus, GA 31709

OR

Fax Purchase Orders to 229.928.9922
 

OR

Call 800.797.5818 for Credit Card orders


Step 5: Additional Comments

(Please provide any additional comments you need to include
as part of your registration; e.g. vegetarian, disabled, etc.)


Step 6: Submit Registration

(You will receive a copy once your registration is submitted and received.)



(Please click this button to submit your registration.)




(Please click this button to erase all information you entered and start entering it again.)



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