RESOLVE of the Bay State

STEP 1: Registration - Choose one of the following options:
Standard Registration - Note: If you are not already a RESOLVE of New England member, join now in Step 3 below and receive the member discount on fees immediately. Continental breakfast and lunch included with registration. Fees include a late fee of $30 beginning Thursday, November 3, 2011
Non- members	$230 – Individual			$325 – 2 People
RESOLVE members	$145 – 1 Person			$225 – 2 People
Family & Friends	$70 per person for 3rd person
Scholarships Available*
Walk-In Registration - Received after Nov. 2, 2011. Lunch is not guaranteed for late registration and an extra $30 fee will be charged - included in price above

STEP 2: Attendee Information
Name:
Name2:
Addl Name:
Address:
City:
State:
Zip:
Phone:
E-mail:
STEP 3: Membership
	If you are not yet a member, join now and save on registration fees:
	$55 - Individual or Household Member
	$150 - Professional Member
STEP 4: Continuing Education Credits
7.2 hours for nurses as established by the MA Board of Nursing; 6.5 hours for social workers as established by the National Association of Social Workers.
	Nursing, License #
	Social Work, License # $35 Processing fee

STEP 5: Workshop Selection
Select only ONE workshop per person for each session. Hint: Make the most of your registration fee. Attend with a partner or friend and register for eight different sessions total!
	Session A	Session B	Session C	Session D
Person 1
Person 2

How did you hear about the conference? Please select the top one or two sources that apply from the following lists:


*Registration fees can be refunded less processing fee with a written cancellation request received by October 29, 2011. No refunds will be given after that date. Financial Assistance is available. Call 781-890-2225 and leave a message or email our office for details.
** Lunch is not guaranteed with walk-in registration