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WCCF 2012 Advocate and Lobby for Kids Day Online Registration

WCCF's 2012 Advocate & Lobby
for Kids Day Registration

Wednesday, March 7, 2012
9:00 AM - 4:30 PM, Madison, Wisconsin
First United Methodist Church, 203 Wisconsin Avenue

Registration/Payment Deadline is Noon, Monday, February 27, 2012
Attendance is limited to maximize participation, so register early!
First Name:
Last Name:
Organization:
Title:
*HOME Street Address 1:
Street Address 2 (if applicable):
City:
State:
Zip/Postal Code:
Phone (Daytime):
Phone (Evening):
Email Address

*Please provide your home address as this will help us in determining your state senator and representative.
SPECIAL REQUIREMENTS: Indicate any you have below:
Vegetarian Meal (Provide details below):

REGISTER ME for Wednesday, March 7! ($40 Registration fee covers training materials, continental breakfast and lunch).

IMPORTANT NOTE: All conference attendees are required to pay the conference registration fee in full prior to attending the conference. You will not be considered "registered" (i.e. no food will be ordered for you and no materials will be prepared for you) until registration payment is received. Thank you for your prompt payment before Noon, Monday, February 27!
 
PAYMENT OPTIONS. Please indicate below the option of your choice:
Credit Card
If you select credit card payment option, once you SUBMIT completed registration form, you will be directed to a secure page to pay for registration online.
Check in the mail and made out to WCCF. Send to:
  Advocate and Lobby for Kids Day 2012
WI Council on Children and Families
555 W. Washington Avenue, Suite 200
Madison, WI 53703
Purchase Order Number:
 

***The registration fee covers all training materials; continental breakfast and lunch on Wednesday, 3/7.


 

  
Wisconsin Council on Children and Families, Inc.
555 West Washington Ave, Suite 200 • Madison, Wisconsin • 53703
Tel 608.284.0580 • Fax 608.284.0583