Registration Deadline: May 21, 2012

Click here to view Conference brochure.

PayPal Payment

Use the buttons below to pay for your registration now. (This is not required. If you do not wish to use the PayPal buttons in this box to pay for your registration now with a credit card or with your PayPal account, go to Step 1 below to complete your registration. If you are paying with a Purchase Order or Check, DO NOT use these boxes.)

Phase I

Phase II

Advanced

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Enter Your Name:

Enter Your School:

Have you already registered?

Enter Your Name:

Enter Your School:

Have you already registered?

Enter Your Name:

Enter Your School:



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

*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

*Please indicate which Conference you will attend:
June 20-22, 2012; San Antonio, Texas


Step 3

Registration Information

(Please provide the indicated information, taking note of the required information.)
*Name:
*Title:
*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 (Pay now by clicking one of the Add to Cart buttons at the top of this page.)
Purchase Order Number :

Pay now by clicking one of the Add to Cart buttons at the top of this page.
 
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 1.800.797.5818 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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