Ticket Quantity*

Cost per person for CEU credit is $125 if registered before February 28

The cost after February 28 is $155

For Survivor/Family Member/Student Rate - non CEU

please call Margaret at 502-493-0609 to register for $30

 

 
Special Needs 2
  • Large Print
  • Sign Language
Please Type Your Discipline:*

Contact Information

Title
First Name*
Middle Name
Last Name*
Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*

Payment Information

Amount*
$
Name on Card*
Card Number*

Security Code

Share This Form

Powered by eTapestry.