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THE EASY WAY!!!!! go to our website www.familiestogether.org and click on register now. OR YOU CAN COMPLETE AND MAIL/FAX THIS FORM.
FTPD - C. Clark Phone us to register at 1-866-326-4864
4417 Great Oak Road OR FAX: 1-509-335-7339
Rockville MD 20853
NAME:____________________________________________________
ADDRESS:_________________________________________________
CITY: _______________________________STATE_______ZIP___________
PHONE: ___________________________
Email:__________________________________
All attendees must register and will receive an email confirmation. Refunds are not allowed. Substitutions are always allowed. Please remind your substitute to bring the confirmation letter. Donation registrations for parent scholarships are always appreciated. Please call 1-866-326-4864 if you do not receive a confirmation notice or you have any other questions. CEUs will be available for an both days for an additional charge.
Please check the amount you are paying.
FAMILY IS IMPORTANT
_____ $65.00 -- Teachers, non profits, or service providers .
_____ $75.00 – General Registration
_____ $20.00 with Parent Scholarship –Limited number available!
_____ $16.00 -- for 8 CEUs for Feb 19
COMPANION WORKSHOP ON BEHAVIOR
_____ $60.00 Companion Workshop on Behavior
_____ $14.00 for 7 CEUS for Feb 18
Total Paid ___________
HOW ARE YOU PAYING?
___I am paying by check . Make checks payable to Families Together for People with Disabilities
___I have enclosed a check or money order for _______
____I am paying the registration fee using a credit card.
1. Click here to register and pay on line Register Now
2. You may also fax your credit card info to: 509-335-7339
Charge my: (circle one) -----Master Card ----Visa. (American Express and Discover can only be used on Acteva)
Account No. ____________________________Exp. Date______________
Name: _____________________________________
Address: ___________________________________
**If paying by credit card, please use name and address to which your credit card bill is mailed.
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