Member?

2003 Reinventing Quality Conference
A 21st Century Architecture for Quality:
Building for the Future

July 30 - August 1, 2003
Holiday Inn Minneapolis Metrodome

- CONFERENCE REGISTRATION FORM -

Please fill in ALL of the registration blanks. This information will be used for your badge and the Attendee Lit to be distributed at the meeting.
First Name

Last Name

FULL NAME FOR BADGE

Title

Phone

Fax

TDD

E-Mail Address:
Agency / Organization

Division

Mailing Address

City

State

Zip

 

Please check the appropriate box(es):

I am planning to attend the Welcome Reception on Wednesday, July 30 (5:30 pm until 7 pm)

I WILL NOT be attending the Welcome Reception.

SPECIAL ACCOMMODATIONS

I have the following special needs
Wheelchair Sign Language Interpreter
Brail Documents Other, please describe below:

DIETARY RESTRICTIONS: Vegetarian Vegan
No red meat Kosher No pork Other (Specify)

In order to help us match the needs of future conference participants, please check the categories that best describe your affiliation (you may check more than one):
Staff
Self Advocate
Parent or Family Member
Advocate
Direct Support Professional
Educator
Consultant / Human Service Professional

Staff of
Provider Organization
County Government
State Agency or Department
Federal Agency
Advocacy Organization
Other

The registration fee is $250 per person. The fee for groups of 6 or more people from the same organization registering together will be $225 per person (registrations must come in a single packet or be submitted on-line together). The fee includes all meeting materials, sessions, morning and afternoon refreshments, the Wednesday Welcome Reception, and the Wednesday and Thursday luncheons. The registration fee DOES NOT include hotel registration or transportation to the conference.

PAYMENT INFORMATION: YOU WILL BE INVOICED FOR THE REGISTRATION FEE
National Association of State Directors of Developmental Disabilities Services
113 Oronoco Street, Alexandria, VA 22314
Tel: 703-683-4202; Fax 703-683-8773