2020 Professional Conference Registration

Full Name *

First Name Last Name

E-mail *

Phone Number *

Area Code Phone Number

Address

Business or Organization

Street Address

City State / Province

Postal / Zip Code Country

What is your profession?

Multiple professions okay (e.g. attorney/guardian ad litem/mediator/advocate/psychologist/social worker)

For attorney and GAL continuing education reporting purposes, what is your bar registration number?

How did you hear about this conference?

Registration Options

Early Bird Registration (iEXTENDED if paid by June 4th)

$ 150.00 Quantity

Regular Registration (if paid after June 4th)

$ 175.00 Quantity

KFC Facilitator Rate

$ 100.00 Quantity

IPV Advocate Rate Includes attorneys and others working for agencies seeking to end domestic violence

$ 50.00 Quantity

Student Rate

$ 50.00 Quantity

Pay it forward and sponsor an IPV advocate or student ticket

$ 50.00 Quantity

Total

$ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Thank you for registering for the 2020 Kids First Center Professional Conference. You will receive a confirming email upon your registration submission. Prior to the first day of the conference, you will receive a second email with login credentials and conference materials. If you have any questions, please do not hesitate to contact the Center at info@kidsfirstcenter.org or (207) 761-2709. We remain available to you.