School Counselors & Members Administrators Parents & Public Press Advertise/Exhibit 2010 Conference Registration Attendee Information Enter Member Number Prefix --- Amb. Br. Col. Del. Dr. Fr. Hon. Min. Miss Mr. Mrs. Ms. Rev. Sr. First Name Middle Name Last Name Suffix --- CSW Ed.D II III IV Jr. LPC LSW MA NCC Ph.D Sr. Address 1 Address 2 City/State/Zip , Alabama Alaska Alberta Arizona Arkansas AE - Armed Forces Europe AP - Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming International Address Country Albania Algeria American Samoa Andorra Angola Anguilla Antigua & Barbuda Argentina Armenia Aruba Australia Austria Azores Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Bosnia Botswana Brazil British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Canary Islands Cape Verde Islands Cayman Islands Central African Republic Central America Chad Channel Islands Chile China Colombia Congo Cook Islands Costa Rica Croatia Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador England Equitorial Guinea Eritrea Estonia Ethiopia Faeroe Islands Federated States of Micronesia Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Holland Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kosrae Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Madeira Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mexico Moldova Monaco Monogolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Norfolk Island Northern Ireland Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Ponape Portugal Puerto Rico Qatar Republic of Ireland Republic of Yemen Reunion Romania Rota Russia Rwanda Saba Saipan San Marino Sao Tome and Principe Saudi Arabia Scotland Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands South Africa South Korea Spain Sri Lanka St. Barthelemy St. Christopher St. Croix St. Eustatius St. John St. Kitts & Nevis St. Lucia St. Maarten St. Martin St. Thomas St. Vincent & the Grenadines Sudan Suriname Swaziland Sweden Switzerland Syria Tahiti Taiwan Tajikistan Tanzania Thailand Tinian Togo Tonga Tortola Trinidad & Tobago Truk Tunisia Turkey Turkmenistan Turks & Caicos Islands Tuvalu Uganda Ukraine Union Island United Arab Emirates United Kingdom United States Uruguay US Virgin Islands Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Gorda Wake Island Wales Wallis & Futuna Islands Western Samoa Yap Yugoslavia Zaire Zambia Zimbabwe Home Phone Work Phone Email Address Work Setting ---- Association/Foundation Career/Development Center College/University Community Agency Elementary Elementary/Middle Federal Government Junior/Community College K-12 Middle/Junior High Other Private Practice Central/School District Office Rehabilitation Center Department of Defense School Secondary/High School State Department of Education State Government Middle/Secondary Current Job/Position: Administrator College Professor/Instructor Director/Coordinator/Supervisor Paraprofessional Prinicipal/Assistant Principal Retired School Counselor School Psychologist Social Worker Student First Time Attendee --- Yes No Previous Conferences Attended --- 0 1 2 3 4 5+ 10+ 15+ 20+ Vegetarian --- Yes No Special Needs? --- Yes No   If yes, please explain. Badge Information Name Name of School/Institution School City School State Alabama Alaska Alberta Arizona Arkansas AE - Armed Forces Europe AP - Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming International Address Pre-Conference Workshops   Full Day (9-4)   $70.00  --- A. Introduction to the ASCA National Model B. Data Does Make a Difference C. Beyond Cultural Awareness to Cultural Competence Half Day AM (9-12) $35.00  --- D. Engaging Boys E. Understanding Children’s Emotional Needs F. Negotiating the Complications of Legal and Ethical Issues G. Sustaining Your ASCA National Model Program H. Courageous Conversations for Counselors Half Day PM (1-4) $35.00  --- I. Why Try? J. Fostering Responsive Relationships K. Accountability Through Evidence-Based Practice M. Web 2.0 Boot Camp Featured Speaker $50.00  Sylinda Gilchrist Banks, Ph.D.     9 am-12 p.m.      Conference Registration Rates You must be logged in to get the member pricing. If the member pricing does not appear, please log in with your username and password. Click Here to log in.           Non Members   $495.00   Presenters   $275.00   Principals   $250.00   One Day 7/3   $175.00   One Day 7/4   $175.00   One Day 7/5   $175.00   One Day 7/6   $175.00   Registrant Options Opening Reception - $0 For Attendees   I wish to attend the opening reception.     I do NOT wish to attend the opening reception.     Recognition Dinner - $75 For Attendees I wish to attend Recognition Dinner.   I do NOT wish to attend Recognition Dinner.     Fourth of July Celebration I wish to attend the Fourth of July Celebration. - $15.00   I do NOT wish to attend the Fourth of July Celebration..     Guest Registration Guest registration is $175. It includes access to the exhibit hall, opening reception, and lunch in the exhibit hall on Sunday and Monday.   Name of Guest 1   Name of Guest 2   Name of Guest 3   Name of Guest 4   Name of Guest 5 Additional Guest Tickets Opening Reception - $30.00 Qty 012345678910 Total $ Recognition Dinner - $75.00 Qty 0 1 2 3 4 5 6 7 8 9 10 Total $ Fourth of July Celebration - $15.00 Qty 0 1 2 3 4 5 6 7 8 9 10 Total $ Payment Type District Credit Card Personal Credit Card   ASCA - 1101 King Street, Suite 625, Alexandria VA 22314 | Contact Us © Copyright 2006-2008 American School Counselor Association. All Rights Reserved.