The Arizona Association for Marriage and Family Therapy
Supporting Arizona’s Marriage and Family Therapists
Caring for Arizona’s Families
A Division of the American Association for Marriage and Family Therapy

AzAMFT 2008 SPRING CONFERENCE
Friday, February 29th & March 1st, 2008

REGISTRATION

CLICK HERE TO DOWNLOAD PRINTABLE REGISTRATION FORM
(Form is in Microsoft Word format)

AzAMFT 2008 Spring Conference Registration

Name:                                                                                                                                    

Address:                                                                                                                                

                                                                                                   Zip:                                      

Phone:       (       )                                            E-mail:                                                            

Registration Includes Friday Continental Breakfast and Lunch, Saturday Brunch

Registration Fees	Postmarked Before 2/1/08	Postmarked After 2/1/08
AzAMFT or AzPA Member	$190.00	$215.00
Non-Member	$220.00	$245.00
AzAMFT Student*	$60.00	$80.00
Student Non-Member*	$70.00	$90.00
AzPA Certificate (Psychologists only)	$10.00	$10.00
California CEU’s  (PCE392)	$10.00	$10.00

* Students must enclose a copy of proof of student registration.

For Friday Lunch Please Select One:
□ Chicken Taco Salad
□ Vegetable Lasagna

Total Enclosed:                                                       

Please indicate the need for any special accommodations:

 

Make Checks Payable to AzAMFT.  Send form & payment to: AzAMFT c/o Ellen LaBelle, 10000 N. 31st Ave., Suite B-110, Phoenix, AZ  85051 or fax form and credit card information to Ellen at (602) 861-3511 (secured fax line). 

Method of Payment: □  Check     □  VISA     □  MasterCard

Amount:                                                       

Cardholder: ____________________________________________________________
                                   (Name exactly as it appears on the card)

Credit Card Number:                                                                                                            

Expiration Date:                                                                                                                   

Signature:                                                                                                                              

NOTE: Cancellation refunds will be accepted in writing up to 72 hours before the conference.  There will be a $15.00 administrative fee.

For more information, contact Marsha Cortese at
(602) 604-8448 or via email at mwcmft@aol.com