Registration Form

 

January 4-8, 2009

Disney’s Contemporary Resort

Walt Disney World® Resort

 

 

$299.00 – Registration rate

$139.00 – SATH member rate (expires November 30, 2008)

$169.00 – SATH member rate (from December 1, 2008)

$159.00 – Special pricing for approved organizations/associations*(expires November 30, 2008)

$189.00 – Special pricing for approved organizations/associations*(from December 1, 2008)

$109.00 – Companion, Spouse, Student, Educator rate*(expires November 30, 2008)

$129.00 – Companion, Spouse, Student, Educator rate*(expires December 1, 2008)

$25.00 – Cancellation fee prior to December 1, 2008

$99.00 – Cancellation fee from December 1, 2008

 

*Contact Susan@sath.org or call 561-361-0017 for details

 

 

Name/Title:_________________________________________________

 

Company:____________________________________________________

 

Address:____________________________________________________

 

City:_______________________State:_________Country__________

 

Telephone:________________________Fax:______________________

 

E-mail:_________________________________________________

 

Method of Payment (check one) o Check o Credit Card

 

Credit Card: Name :_________________________________________

 

Number:______________________________________________________

 

Exp.Date:_________________

 

Name on Card:_______________________________________________

 

I hereby authorize SATH Conference to charge the congress registration fees to my credit card.

 

Signature:______________________________________Date:_______

 

 

 

If You Have A Disability, Please Complete The Following.

 

What is your disability?___________________________________

 

Do you need ASL interpretation for meetings?

Yes No

 

Do you need a wheelchair accessible hotel room?

Yes No

 

Do you need the agenda in an alternate format?

Yes No

 

Do you need a roll-in shower?

Yes No

 

Do you need wheelchair accessible transfers?

Yes No

 

If you need any special facilities because of your disability, please state below.

____________________________________________________________

 

____________________________________________________________

 

 

This form must be printed out and e-mailed, mailed or faxed to us. The web site does not support transmission.

 

For further information contact

 

Susan, SATH Congress Coordinator:

Tel: 561-361-0017

Fax: 561-361-0224

Email: susan@sath.org