The Standing Up To Bullying Conference (Onsite)

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Participant Pre-Registration Form Instructions
  1. Please complete, print, and submit this pre-registration form before the RSVP date of the conference you wish to attend.
  2. If you pay your conference fee online, you will receive a 10% discount.
  3. You will receive a complete refund provided that you notify Building Strong Families National Seminars at Cancellation@StrongFamilies.us of your need to cancel at least one-week prior to the conference date.
  4. Please download and print the "Standing Up To Bullying" Conference Handout after submitting this pre-registration form and bring it with you to the conference. If you do not have PDF already installed on your computer, please click here to download this free reader.

**** If you or your staff would like to attend this conference but the diminished economic climate is making finances difficult, please email us at Info@StrongFamilies.us so that we can negotiate an appropriate discount. ****

Pre-Registration Form

Please complete the following form to pre-register yourself or a group of people (more than one). If you are pre-registering at multiple conference locations please complete this form once per location. Please place a check mark next to the conference location you plan to attend.


Location 1

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  • Venue's Map and Directions:

Location 2

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Location 3

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  • Conference Fee: $60.00
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Location 4

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Location 5

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Location 6

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Location 7

  • Venue Name:
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Pre-registration Details

Please complete the requested information below. If you are pre-registering a group, please enter the following information one name per line in the boxes below. In addition, if your group selects to pay the conference fee online, please list the number of people that you are pre-registering on the payment site so that the 10% discounted fee is adjusted:


First/Last Name(s)*


Email Address(es)*


Telephone Number(s):*

(Optional) To customize and maximize your conference experience, please list in the box below the conference topic(s) as described above that you would like highlighted and/or request a topic(s) that is/are related to youth bullying and school violence that you would like discussed during the conference. Your request will be considered:



Payment Options


**** If you or your staff would like to attend this conference but the diminished economic climate is making finances difficult, please email us at Info@StrongFamilies.us so that we can negotiate an appropriate discount. ****


Payment for the conference can be made in three ways:

1st Payment Option

You or your group can pay the conference fee online using PayPal reflecting the 10% discount.


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2nd Payment Option

You or your group can mail a check to the following address:

Building Strong Families National Seminars
P.O. Box 1742
Surprise, AZ 85378-1742

Checks need to be payable to Building Strong Families National
Seminars
.


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3rd Payment Option

You or your group can bring a check to the conference. Checks need to be payable to Building Strong Families National Seminars.


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Please select the payment option that
identifies the way you plan to pay for the conference.

Would you like to have an invoice emailed to you?

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