Social Work and Religious Diversity Conference Registration

 

Please Note:  All fields marked with an asterisk (*) are required for registration.

 

If you have any questions about registration, please email henry@interfaithcenter.org, or call 212-870-3514.

 

 

Contact Information

Degrees/Licenses
Organization/Affiliation*
Position/Job Title
Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*
 
 
 

Additional Information

Would you like us to include your name, affiliation, and email address on a contact list for conference participants?*
  • Yes
  • No

 

 

 

How did you hear about this conference?
 
 
 
Lunch, snacks, coffee, and tea will be provided for all conference participants.  We will have both vegetarian and meat options for lunch.  If you have more specific dietary needs or restrictions (eg, strictly kosher) please let us know.  We may not be able to accommodate everyone, but we'll do our best!
Specific Dietary Needs or Restrictions?

 

 

 

If you are registering (at a 10% discount) with a group of three or more participants from one organization, list the names of your colleagues here.  Please note: this listing does not constitute a conference registration.  Each colleague must submit their own individual registration form.

Colleagues Registering with You?

 

 

 

Registration Status and Cost

 

Select your registration status below, with or without the administrative fee for continuing education credits.  Be sure to enter 1 for "Quantity" -- each conference participant must complete their own individual registration form.

 

Quantity
Price
Total
Standard Registration
X
$
130.00=
$
0

Standard Registration, plus Continuing Education Credits
X
$
160.00=
$
0

With a Group of 3 or More from One Agency
X
$
117.00=
$
0

With a Group of 3 or More, plus Continuing Ed. Credits
X
$
144.00=
$
0

JBFCS or PSI Staff
X
$
97.00=
$
0

JBFCS or PSI Staff, plus Continuing Ed. Credits
X
$
120.00=
$
0

Full Time Graduate Student
X
$
65.00=
$
0

Final Total:
$
0

 

 

 

Payment Information

Amount*
$
Name on Card*
Card Number*

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