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2009 Annual National Conference

(Information subject to change without notice.)

Today's Date
First Name
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College Name
Street Address
Street Address
City
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Zip Code
Phone
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Email

Meal Preference:

Request for ADA Accommodations

To request ADA accommodation(s), please do the following:

  1. Submit an e-mail request to gloria.schoonover@mcmail.maricopa.edu on or before April 15, 2009. The e-mail subject line needs to read "ADA Accommodation Request".
  2. Indicate the ADA accommodation(s) requested below and submit your registration on or before April 15, 2009.

    ADA accommodations requested:

Please continue to scroll down
to complete registration.

Conference Fees

Main Conference Fees:

Registration fee includes keynote speakers, concurrent sessions, conference materials, four meals and three refreshment breaks.

There will be a $50 registration cancellation fee prior to April 17. Registration fees are not refundable after April 17. Note: Registrations are transferable.

By April 17 After April 17
Early Bird Registration $425
$450
Community Agency/Partners $375
$375
Student $300
$325
Presenter $350
$350
One-Day Only $225 $250
Which Day:
Other -- Please Explain:

Pre-Conference Selection:

A pre-conference will be held on Wednesday, May 20, 2009. The pre-conference fee is separate and in addition to the regular conference fee. If you will be attending the pre-conference, please select the applicable fee and make your workshop selections:

Pre-Conference Fees (in addition to above):

  By April 17 After April 17 Other
Participant $150 $175
-- Please Explain:
Presenter $125 $125
-- Please Explain:

Morning Pre-Conference Selection:

Afternoon Pre-Conference Selection:

Fee Acceptance:

Your TOTAL conference fee includes both your main conference fee plus your pre-conference fee.

Main Conference Fee:
Pre-Conference Fee:
Total Conference Fee:

Do you accept these charges?Yes
No, and I understand that my registration will not be processed.

PO/Check Number (if applicable)


Enter purchase order number or check number if applicable. (This field is optional. You need not have a check or PO number before registering. We will mail you an invoice upon receiving your registration.) We do not accept credit cards.

Please make checks payable to the Community College National Center for Community Engagement.
 

Our Federal ID Number is 86-0185552.
Our DUNS Number is 077521664

Please continue to scroll down to the END of this form to complete registration process.
Sending In Registration

Photography and Participant Release: Submission of your conference registration authorizes CCNCCE to publish in any format and use for any purposes your name, affiliation, and any photographs, video footage, and audio recording taken of you at the 2009 Annual National Conference.

Make sure you have filled the form out completely. Incomplete registration forms that are submitted will not be considered valid registrations.

PLEASE USE THE MENU AT THE TOP OF YOUR BROWSER SCREEN TO PRINT A COPY OF YOUR REGISTRATION.

If our college is having server problems and your registration does not go through, please fax your printed copy of it to 480-461-6284. Thanks!

If you do not receive e-mail confirmation of this registration, please contact Gloria Schoonover.
Email: gloria.schoonover@mcmail.maricopa.edu
Phone: (480)461-6280

If you receive a message stating that your registration form was not sent or did not go through, it may be because our server is temporarily down for maintenance. Please either try to send your registration in again after approximately four hours or make a printed copy of it and either fax it to 480-461-6284 or mail it to Community College National Center for Community Engagement, 1025 North Country Club Drive, Suite 320, Mesa, AZ 85201. Thank you.


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More information on this conference will be posted as it becomes available. This information is subject to change. For more information, please contact Gloria Schoonover at 480-461-6280 or email her at schoonover@mesacc.edu.

Please check back with us soon for further details.