Presenter/Exhibitor Online Registration Form
Complete this form and submit electronically by clicking on the "Submit" button below. The
conference registration fee can be paid by credit card, check/money order by mail, or purchase
order. Please check payment method below. After completing and submitting form, pay
registration fee using your credit card by clicking on the Pay Pal button below. You may
preregister using this form when sending payment by mail or paying on site. To receive early
registration rate of $30.00, payment must be postmarked by 10/29/10 (or you must
preregister by this date, if paying on site). Please indicate below that you are preregistering
online and mailing payment or paying on site. If you would like to register by mail, download
and complete Conference Registration Form.
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2010 Oklahoma Indian Child Welfare Conference
"Knowledge, Resources, and Culture: Keys to Building Strong Families and Nations"
Dates: November 18-19, 2010
Registration Fees: $30.00 ($45.00 after 10/29/10)
Cancellation: Refunds minus $10 administration fee will be made if written notice is faxed or
mailed on or before 10/29/10. Prepaid registrants unable to attend may send another person
in his/her place..
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Your name:
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Job Title:
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Agency/Organization/
Tribe/Tribal Affiliation:
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Mailing Address:
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City/State/Zip Code:
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Phone Number:
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Fax Number:
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Email Address:
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Comments:
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How will you pay registration fee? (Please Check One)
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By Credit Card (Use PayPal)
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Check or Money Order By Mail (Preregister)
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Purchase Order
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PO #:
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Check or Money Order On Site (Preregister)
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Please click Submit after completing fields. Submission is not complete until you are
directed to a confirmation web page screen. To pay registration fee with a credit
card, click on the PayPal button located on the confirmation web page screen.
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