Registration Form

2008 Catalyst for CARE Annual Conference

Connecting Caring Communities: Tying it Together

May 21-23, 2008

The Hilton Desoto

Savannah, Georgia

Name: _______________________________________ Title:__________________________________

Agency: _____________________________________ Phone: ________________________________

Address: __________________________________City:_________State:_____Zip:_______________

Fax:_________________________ Email: _________________________________________________

Special Needs: ______________________________________ Vegetarian Meal: ___Yes____No

Workshop Selection: On the following lines, please indicate your choices for each workshop you plan to attend.

(example: A1, B1, C2, E4, etc.)

(Session A) Wednesday, May 21 1:00-2:30 _____

(Session B) Wednesday, May 21 2:45-4:15 _____

(Session C) Thursday, May 22 10:15-11:45 _____

(Session D) Thursday, May 22 1:00-2:30 _____

(Session E) Thursday, May 22 2:45-4:15 _____

(Session F) Friday, May 23 8:30-10:00 _____

(Session G) Friday, May 23 10:15-11:45 _____

(Session H) Friday, May 23 11:45-1:00 _____

Early Bird Registration ………. $190.00

(Extended Early Bird Registration Rate now through April 23rd!)

Regular Registration ……………$225.00

(Received after April 23, 2008)

Late/On Site Registration……....$300.00

(Received after May 12 , 2008

One Day Registration Rates:

Wednesday $70 _______

Thursday $100 ______

Friday $60 _______

Please note: All cancellation requests must be submitted at least 7 days prior to the conference. To request a refund on registration, you must complete a Cancellation Form. You may download the form online at www.catalystforcare.org or contact Jessica Cole at 404-298-0327 or Jessica@catalystforcare.org. Your cancellation WILL NOT be processed unless this form is completed.

Payment Information

Please remit payment with registration. You may also pay by credit card. Catalyst for CARE accepts Visa, MasterCard, and American Express. Credit card registrations may be phoned in to 404-572-6178 or entered online at www.catalystforcare.org. Please note that your registration is not complete until we receive payment

Card Type __________________ Credit Card Number: __________________________________

Expiration Date: ____/____/____ Security Code _______________________________________

Billing Name: _____________________ Phone number: ______________________________________

Billing Address: _______________________________________________________________________

City: _________________________ State:______ Check Number (if applicable) ___________________

Subtotal: ______________

CEU Fee: _____________ ($15)

Additional lunch guest ($30 each) ________________

Total Due: _____________

CANCELLATION POLICY: Request for refunds must be received in writing no later than May 14, 2008. A $75 service fee will be charged on all cancellations. Refunds are not processed until after the conference and will take 6-8 weeks.

Checks and registration forms should be made payable to Catalyst for CARE and mailed to:

2008 Annual Conference

C/o Catalyst for CARE

34 Peachtree St., NW, Suite 2230

Atlanta, GA 30303

If you have any questions regarding registration information, please contact the Catalyst for CARE office at 404-298-0327 or Jessica@catalystforcare.org.

In accordance with the American with Disabilities Act, please call 404-572-6178 if you have any special needs or dietary requirements.