*Student status will be taken on faith.
** Registration of children implies registration of a parent or other person 18+ to be responsible for the registered children. This does not apply to registrants for the YA program.
We have nothing prepared for children 5 and below. Children over 12 are deemed to be Young Adults.
Note: The family rate is available for families who are registering at least three people. Friday registrations are not counted toward the family rate.
If you have questions, you can
reach us by email or leave a message at 978-300-5432.
*************************
General Information:
Name:
Street Address:
City: _________________State/Province: ______Postal Code: ____________
Country: ______________Phone Number: _____________Fax: ______________
Email: ______________________Institution (if any): ________________________
Total Fees: $_____.00 + Donation (optional): $______ = Total Amount Enclosed: $________
I am registering a family and would like apply the discount:
Reminder: Checks should be made payable to Gifted Conference Planners.
Attendee Information:
Number of Attendees: (You may include additional copies of the third page as needed.)
Attendee 1:
Name:
__________________________
Age group: Adult Child (Age: __)
YA/Grad Student
Email (if
different): __________________________
Institution:
Sessions Attending:
Friday Saturday Sunday
If you selected Friday, please tell us your primary
role(s):
Teacher Administrator Parent
Counselor/Therapist Fees: $______ Graduate Student
Attendee 2:
Name:
__________________________
Age group: Adult Child (Age: __)
YA/Grad Student
Email (if
different): __________________________
Institution:
Sessions Attending:
Friday Saturday Sunday
If you selected Friday, please tell us your primary
role(s):
Teacher Administrator Parent
Fees: $______ Counselor/Therapist Graduate Student
Attendee 3:
Name:
__________________________
Age group: Adult Child (Age: __)
YA/Grad Student
Email (if
different): __________________________
Institution:
Sessions Attending:
Friday Saturday Sunday
If you selected Friday, please tell us your primary
role(s):
Teacher Administrator Parent
Fees: $______ Counselor/Therapist Graduate Student
Attendee 4:
Name:
__________________________
Age group: Adult Child
(Age: __)
YA/Grad Student
Email (if
different): __________________________
Institution:
Sessions Attending:
Friday Saturday Sunday
If you selected Friday, please tell us your primary
role(s):
Teacher Administrator Parent
Counselor/Therapist Graduate Student
#prices and details subject to change without notice