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2010 Conference Registration Form

Conference Theme: "3 Dimensional Renewal: Personal, Spiritual, Professional"

Keynote Speaker: Dr. Dan B. Allender, Ph.D.

Banquet Speaker: Dr. David Griffin


Our Location Is the Marriott Austin Airport South 4415 S. IH-35, Austin

Room rates are $119.95 for a single or double (parking is FREE)

Click on this link to make your hotel reservations
Hotel Reservations
Please do not call the hotel for reservations.

If you have difficulty in making a reservation e-mail or call Helen Tidwell.
E-mail: htidwell@plazatravelinc.com Ph: 800-752-1191

 

 

 


Please Note: Fill in the needed information below and click submit. A conference payment form will appear. Make your conference registration selection; you will then be taken to a Pay Pal cart. Click "Continue Shopping" to make more selections. Continue until all your selections have been made. If your browser opens a new tab you will have to click on the previous tab to continue adding items to your Pay Pal cart.

Credit card payments will be securely handled by Pay Pal.

 

Name:
Registration:
Regular Registration (postmark before February 04, 2010 - Banquet NOT included in conference cost)
Regular Member cost $210 Non-Member cost $250

One Day (Banquet NOT included in conference cost)
Member cost $185 Non-Member cost $225

Half Day
Member cost $70 Non-Member cost $85 (Banquet NOT included in conference cost)

Student
Undergraduate / Graduate Cost $75 (Banquet NOT included in conference cost)

Spouse / Friend Attending
Cost $110 (Luncheon & Banquet NOT included in conference cost. No CEUs given.)

Thursday night Banquet
Yes, I will be attending the banquet. Cost is $35 per person.

I will need additional reservations not including mine($35 ea)

Additional Luncheon Reservations
Yes, I need additional luncheon reservations ($18 each).
One luncheon reservation is included in price of Early Bird, Regular and on site conference fee.
One day, Half day, Student and Spouse/Friend must purchase reservation.

Membership

Renewal Professional Membership New Professional Member ...................(New members must submit a membership application)

LPC MSW LMFT Psychologist Psychiatrist

Other

Associate Membership $60

Renewal Associate Membership New Associate Member

Ministry - Explain:

Student Renewal Membership $30 (New Students first year is free)

Renewal Student Membership New Student Member

Student at University:

Retired Membership $40

Renewal Retired Membership New Retired Member

Comments:

Address:

City: State: Zip Code:

Bus. Phone :
Email Address:
Note: We are interested in your membership in CCT. If you have any questions please contact us.

                      

Please Be Sure You Make Payment After You Register

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Christian Counselors of Texas, Inc. PO Box 9816 - Midland, TX 79708-9816

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