Conference Registration 2015

Annual Conference: November 20-21, 2015

School Counselors: Advocating Access for All

Sagamore Resort

Bolton Landing

Name (One Registration form per person)

First Name *

Last Name *

E-mail *

Phone Number-include area code *

Institution Name *

Address

Street Address (If Work: School or Business Address *

Address Line 2

City *

State *

Zip Code *

Region and/or County

Position Title *

Work Setting *

Are you currently a NYSSCA Member? (NYSSCA Membership must be current through December 2015 to qualify for Member Rate (contact membership@NYSSCA.ORG if you have a question regarding your membership) *

Are you an ASCA Member?

Are you a first time conference attendee? *

Please Check One Registration Type. Registration options will then appear. Registration includes breakfast, lunch, coffee breaks & Conference Materials. Early Bird Registration MUST be submitted by October 23, 2015. If you are uncertain about your membership status, contact Membership@NYSSCA.ORG

Registration Type *

NYSSCA Member Non-Member (Includes 1 year NYSSCA Membership) Graduate Student Presenter Volunteer (Approved Only) by Volunteer Coordinator, Joan Cawley. Email Joan at Region6Gov@NYSSCA.Org before registering

NYSSCA Member *

Early Bird Registration $235 (by Oct 23, 2015) Regular/On-site Registration $260 Friday Only $160 Saturday Only $145

Non-member (includes 1 year NYSSCA Membership) *

Early Bird Registration $285 (by Oct 23, 2015) Regular/On-site Registration $310 Friday Only $ 205 Saturday Only $195

Graduate Student (includes 1 year membership) *

Early Bird Registration $225 (by Oct 23, 2015) Regular/On Site Registration $235 Friday Only $150 Saturday Only $140

Volunteers APPROVED ONLY *

$155

Presenters *

I will only attend my scheduled Presentation (please remember to Submit your application) Full Conference $155 Friday Only $85 Saturday Only $75

Form of Payment *

Check (Please print a copy of this registration form to include with your payment and mail to NYSSCA, Box 217 Leicester, NY 14481) Purchase Order (Either attach PO to this form below or mail to NYSSCA Treasurer, 25 William Ave, Central Islip, NY 11722) Make sure that your name is on the purchase order. Credit Card Presenting Only

Total Due-Check or Purchase Order *

Purchase Order Attachment-Please attach your purchase order here or mail to NYSSCA Treasurer, 25 William Ave, Central Islip, NY 11722. Make sure your name is on the PO.

Credit Card Registration-Please enter your registration total here.

USD NYSSCA 2015 Conference Registration

Unless paid by credit card, mail payment to: NYSSCA, P.O. Box 217, Leicester, NY 14481, attention Registration Chair with a copy of your email receipt or a printout this form -Checks and purchase orders must be payable to NYSSCA -No refunds unless requested prior to 11/12/2015. You may substitute a colleague by 11/18/2015 -Conference & hotel information available at www.nyssca.org -Make room reservations directly with the Sagamore HERE or 866-384-1944 USE Conference Code NYSSCA2015 for conference room rate. -Send conference questions to info@nyssca.org -Send Registration questions to: Sandy Braun, Registration Chair, at registration@nyssca.org