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2008 National Smart Start Conference

Please note each conference attendee must be registered separately
Step 1: Personal Information
All areas marked with an * must be filled in prior to submitting this form.
First Name*
Address*
Last Name*
City*
Job Title

State*

Country

 Zip*
Organization
Phone*
Email*
Fax
re-enter Email*
.
 What meals will you attend?
 Please check all that apply
No Meals
May 7 Reception
NC Local Partnership Staff
May 8 Dinner
NC Local Partnership Board
 
NC Partnership Board
 
Early Care and Education
Health
 Other meal information
Are you a Vegetarian?
Parent
Are you a Vegan?
Family Support
Any ADA requirements?
Government
Business
 Payment Type
Nonprofit
Check
National Organization
Visa or Mastercard
CCR&R
Name On CC
Faith Community
 
College/University
 
Outside NC
PAYMENT Deadlines (per person)
Early Bird (now until Feb 14, 2008) - $150
Regular Registration (April 3, 2008) - $200
Late or Onsite Registration (after April 3, 2008) - $300
How many years have you been involved in the early childhood field as a professional or volunteer?
Less than 2 years
2-5 years
5-10 years
10+ years
Is this your first time attending the National Smart Start Conference?
Yes
No

Total Cost $

Please note each conference attendee must be registered separately