SPONSORS Stop Meth in Florida

Florida Insurance Trust

2010 Adolecent Conference


To register, please complete the form below and click the submit button. You will receive payment information based on your selected method of payment.
Fields marked with * are required.

First Name: *
Last Name: *
Agency: *
Address: *
City: *
State: *
Zip Code: *
Email Address: *
Phone: *
Fax:

Professional Affiliation
Department of Children and Families
Department of Juvenile Justice
Treatment Provider
Law Enforcement
Educator
Other

Registration Fees:

Full Two-Day Conference - Monday and Tuesday
Includes luncheon, CEUs/Contact Hours
$200 FJJA or FADAA Member
$215 State Employee
$240 Non-member


Single Conference Day registration fee (Monday or Tuesday):
$135 Monday Only (includes luncheon, CEUs/Contact Hours)
$125 Tuesday Only (includes CEUs/Contact Hours)

Special Needs
Please let us know if you have special access or dietary needs. Provide a full description of your needs in the space below. FADAA must be informed of your special needs no later than February 6, 2009 in order to accommodate them.

PAYMENT INFORMATION*

Please let us know how you prefer to pay for your conference registration:
Check or Purchase Order
Credit Card

Comptroller or Billing Contact Information:

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