FALL WORKSHOP 2000
On-Line Registration
Tuesday, October 17, 2000
Camp Otterbein - Logan, Ohio
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.

PAYMENT

Please make sure your check is postmarked no later than September 30 to receive the early bird discount. Checks postmarked after September 30 pay late fee. Note for those registering for Project Learning Tree registration is due by September 22.

Mail your check to:

ACA Ohio Section
28706 Euclid Avenue
Wickliffe, OH 44092

All confirmations will be by e-mail unless otherwise noted.

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.