2000 ACA Ohio Section Annual Meeting On-Line Registration

	2000 ANNUAL MEETING On-Line Registration
	Thursday, January 27, 2000 Fawcett Center - Columbus, Ohio (map and directions)

Hint: Move your cursor to the inside of each box, then click, then start typing. When you're done typing inside the box, DON'T press the ENTER key, just move your cursor to the next box (pressing the TAB key will also work). Pressing the ENTER key is the same as clicking on the "Send Info" button at the bottom, and it may send off this form for processing before you're done completing it.

*** PLEASE COMPLETE INFORMATION IN ALL THE BOXES SO THAT THIS FORM CAN BE PROCESSED SUCCESSFULLY. ENTER "N/A" IF NO INFORMATION AVAILABLE ***

Name (as it should appear on badge)

E-Mail Address

Individual ACA #

Title / Occupation

Camp / Agency / Organization

Address
City, State and Zip (+4, if known)	Phone w/ Area Code

Please Select One....

Although the following selections are not binding, please select your preferences for which sessions you'd like to attend, so we can get an idea of attendance and optimal room size. Detailed session descriptions are on-line. Thanks.

10:45 AM to Noon

1:45 PM to 3:00 PM

3:15 PM to 4:30 PM

PAYMENT

Fee includes participation in workshops and lunch.

REMINDER: If you register on-line or by fax, you must have your registration fee postmarked by January 17 to avoid late registration payment.

ACA Member (with individual's ACA number) - $30
ACA Non-Member - $40
ALL REGISTRATIONS OR CHECKS POSTMARKED AFTER JANUARY 17, 2000 - $50

Mail your check to:

ACA Ohio Section
28706 Euclid Avenue
Wickliffe, OH 44092

All registrations received by January 17 will receive a confirmation by e-mail. If e-mail is not available, a postcard will be sent.

Comments? Questions?

Please type in any additional comments or questions below:

This will compile the above info and send it via e-mail message to the Secretary and the Chair of the Education Committee.
This will clear all the above info entered so you can start over.